BusinessWeek had a wonderful cover article last week about the myth of evidence-based medicine, as Dr. David Eddy has spent a career in illustrating to other doctors and anybody else who will listen. As noted below, somewhere in the range of 20-25% of our medicine practices are evidence-based — that is, there is strong objective research evidence to support a particular treatment or intervention for a particular medical problem or disease. Most of what doctors do is based upon their own clinical judgment — judgment, which is often based upon conventional wisdom (“This is just how we’ve always treated this problem”), which is often just plain wrong.

He proved that doctors had little clue about the success rate of procedures such as surgery for enlarged prostates. He traced one common practice — preventing women from giving birth vaginally if they had previously had a cesarean — to the recommendation of one lone doctor. Indeed, when he began taking on medicine’s sacred cows, Eddy liked to cite a figure that only 15% of what doctors did was backed by hard evidence.

A great many doctors and health-care quality experts have come to endorse Eddy’s critique. And while there has been progress in recent years, most of these physicians say the portion of medicine that has been proven effective is still outrageously low — in the range of 20% to 25%. “We don’t have the evidence [that treatments work], and we are not investing very much in getting the evidence,” says Dr. Stephen C. Schoenbaum, executive vice-president of the Commonwealth Fund and former president of Harvard Pilgrim Health Care Inc.

It’s an interesting article and definitely worth a read. It gives people another reminder as to why it pays to become an informed and educated patient — because doing so leads to empowered patients who make better-informed decisions about their own health, rather than relying on the doctor’s judgment alone.

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

Like this author?
Catch up on other posts by John M. Grohol, PsyD (or subscribe to their feed).

Comments

This post currently has 3 comments. You can read the comments or leave your own thoughts on our new comments page.

Trackbacks

No trackbacks yet to this post.

    Last reviewed: By John M. Grohol, Psy.D. on 30 May 2006
    Published on PsychCentral.com. All rights reserved.