• Eminence based care

    As I’ve mentioned before, I picked up the term “eminence based medicine” from Ashish Jha. It’s a great phrase. Apt, in some cases. But I worry it might be offensive to physicians. So, I did some searching and found that (a) it is not a new term and (b) physicians have used it themselves. Below are some citations.

    • David Isaacs, clinical professor, and Dominic Fitzgerald, staff physician, in a BMJ paper (1999). Very short, fun, and worth a look.
    • Darrell G. Kirch, M.D, president of the Association of American Medical Colleges, in a presentation to the Institute of Medicine (2006, pdf)
    • Valentina Baltag, Véronique Filippi, and Alberta Bacci, in The International Journal for Quality in Health Care (January 2012)

    There are many more. Conclusion: The term “eminence based medicine” is physician-approved, economist-recommended.


    • I dont find if offensive, but I think you need to remember that not everything is amenable to a study. It is not possible to get funding for all of the studies we would like to have. There will always be some eminence based medicine, and it is not always a bad thing. The alternative is to have everyone do their own thing.


      • Good point. OTOH, I wonder if there are examples where variation would be welcome, if only to inform observational studies.

        • Sure. When all you have is level III evidence, people are less likely to comply as strongly with it. I think most of us really would like to have that level I evidence. What I think you, and other economists, can help us with is total dependence upon the RCT study. They are time consuming and expensive. Your observations about IV studies offer a way for us to get more bang for our buck out of research dollars.