Tuesday, September 18, 2012

8. Beware of Evidence-Based Medicine

My job as a physician is to find breast cancer as early as possible so that my patients can
have the best chance for complete cure with as little treatment and potential complication
as possible. Any new technology that can help me to do my job more effectively, that is, that
makes life better, healthier and longer for my patients, is technology that I want to be able to
use as soon as possible.

In Obamacare, and elsewhere in medicine these days, you’ll hear the term “evidence-
based medicine”: the notion that we should only employ and encourage the use of medical
techniques and technology that have proven their value over time and have been well-
documented in multiple medical research studies. Sounds great right?

Let me give you an example of how this works in the real world of taking care of patients:

Digital mammography came out in the early 1990’s, but it took several years for the FDA to
approve it for general use. It was very clear that the digital technology allowed doctors to see
potential breast cancers easier and earlier, giving patients a better chance for survival or cure.
It also involves less radiation exposure to the patient. In spite of its high costs, when it was
finally approved, most breast centers scrambled to get it installed.

By 2008, I had been using digital mammography for many years. In talking to other groups
in town, I learned that every one had digital mammography except the managed care group
that used evidence-based medicine to determine whether or not they would adopt a new
technology or practice. They were still using the old film-screen mammography. They were
waiting for a few more studies to be published proving that digital mammography really was
better. They didn’t plan on adopting digital mammography for another 5 years or so because
of this requirement!

The bottom line here is this: Relying solely on Evidence-based Medicine will destroy
potentially life-saving innovation in our healthcare industry by not allowing practitioners to
adopt potentially life-saving new technology as soon as it is developed. If new technology
can’t be adopted readily, companies will have no incentive to develop it. Socialized medicine
throughout the world strongly advocates for Evidence-based medicine. We are the only
country left without largely socialized medicine. THAT’S part of why 90% of the world’s new
medical technology is developed here in the US. We’ll talk about another reason tomorrow.

So, beware of a healthcare plan that depends heavily on “evidence-based medicine”, like
Obamacare does---your life may depend on it!

(Note: This commentary is by Dr. Jill Vecchio.) 

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