Sunday, November 06, 2005

The Threat of Evidence-Based Medicine

While catching up on my reading, I noticed that the September, 2005 issue of the American Hospital Association’s journal H&HN (Hospitals & Health Networks) included a special article on Evidence-Based Medicine (EBM).

EBM was defined as the “conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”

That sounds about as wholesome as motherhood and apple pie and might lead one to conclude that there was nothing controversial about it.

Not so. After listing a number of arguments in favor of EBM, the article presented the views of critics within the medical profession who believe that EBM standards:

- introduce disincentives for individual innovations in care and healthy competition among practitioners

- threaten to bring about stagnation and bland uniformity in care

- may create a lower level of safety by diminishing practitioner’s skills

- encourage providers to treat all patients as interchangeable

- poorly equip doctors to contend with the variations they will encounter in actual clinical settings

- may lead to the replacement of traditional health care professionals by less expensive, less skilled workers, who may be incapable of operating effectively in diverse situations

It’s an indication of what health care reform is up against.

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