Bazian’s Tom Donald responds to critics of evidence-based-medicine in
our post discussing the company’s
new approach to the controversial field.
"Unfortunately EBM has, in many circles, become a “dirty word” through its
blunt application by insurers and regulators, as well as its devaluation by groups (mostly published products) who say they’re evidence-based when they’re
not. EBM does, however, play a critical function, as you note. So it’s time
for a fresh start. The sullying of its reputation leads us all to evidology –
aka EBM 2.0. Evidology recognises that “getting evidence based” requires a new
specialisation, one which sits between the clinical front line and the bean
counters, assuring quality care without wasteful expenditures. As a company,
we’re working towards the day when evidology bridges the clinicians’ world to
the bean counters’ world, allowing them to better understand each others
needs, requirements and decisions."
Bob Mooney has this to say to critics who think too much time is spent at medical schools teaching prospective doctors to "think like entrepreneurs" and not enough on the trickier subject of teaching them how to cost-effectively treat disease.
"What you learn in school and during training is how to diagnose and to treat disease. As Dr. Bradley observes, little attention is payed to doing so in a cost effective manner. There are physicians who are positioned so as to have a financial incentive to order diagnostic testing."
Most physicians, however, have no such incentive. We see a patient and we try
to get through the encounter without overlooking something that will cause us
to have to face the patient months or years later having to own up to the fact
that we missed a diagnosis. Every office encounter presents an opportunity to
make a mistake that is going to get us sued. We don’t know what the MRI
costs, what the CT scan costs, or what cost is of the exhaustive laboratory
workup that our patient is demanding to explain why they are always tired."
Xoova VP of Communications, Miriam Bookey was so inspired by the post on the HEALTH AFFAIRS
interview with Regina Herzlinger that she wrote to us. (Disclosure, as
required by the unwritten Geneva convention for blogs we now humbly disclose the fact that Xoova is a Health 2.0 sponsor.)
"I know more about my Raisin Bran than about the guy who delivered my
children or the hospital in which he practiced. That’s because there’s
no consumer market yet in health care, and these information
organizations exist only in consumer market." — Regina Herzlinger Yes, there’s a need for physician ratings, and there are resources on the
Internet that already provide that. But we need more than the nutrition label on
the side of the cereal box. We need a real connection with the doctors who
provide our care, because selecting a doctor is both an intellectual and an
emotional choice. That’s where an enhanced profile rather than a simple
directory listing can make a difference. Today we have thousands of enhanced
physician profiles nationwide, and in time, Xoova aims to be the most popular,
trafficked site for doctors to communicate directly to patients. Today they can
do this by updating their own profiles, offering forms for download, and adding
online appointment scheduling…for free. Soon we’ll incorporate the consumer
voice in moderated testimonials, along with physician to physician referrals.
Hopefully, this will take us a step further to the world Herzlinger envisions in
which we know as much about the person who, say, performs our mastectomy as we
know about the restaurant that prepares our dinner …"
