• Misplaced optimism

    Interesting piece in the NYT over the weekend on evidence based management. Enitled “Trust the Evidence, Not Your Instincts“, it details how in many industries, people are beginning to rely more on research and data than on instinct. As you can imagine, I approve.

    But the piece begins this way:

    CONSIDER this hypothetical situation: You have a serious illness. Your doctor prescribes an intrusive, painful and costly treatment. What she doesn’t say — because she hasn’t consulted the research — is that most studies find the treatment ineffective and fraught with negative side effects.

    You go through the procedure, which doesn’t work. You later find the research your doctor failed to consult. When you ask why, she answers: “Who pays attention to studies? I have years of clinical experience. Besides, the protocol seemed as if it ought to work.”

    Does that sound like malpractice? It does to us. Fortunately, pressures to practice evidence-based medicine are reducing preventable errors.

    I wish that was the case. But as we have discussed over and over and over again on this blog, getting the health care system to do this is incredibly difficult. And, despite the beliefs of the authors of this piece, we’re not doing nearly as well in medicine as we should be.

    Back to work.

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    • I think the natural optimism that I am told all humans except the depressed have, is a big problem in cases like you described. One would expect the insurance companies to refuse to pay for procedures that have little evidence but that angers their customers too much. That is one of the reasons that many of us advocate more skin from the end customers. If it will cost them something they and their providers may choose to forgo low benefit high cost procedures.