A refreshing opinion piece in the New York Times about the importance about being honest about the strength of the scientific evidence and giving weight to patient preferences in making treatment decisions. These concepts are central to the recently published International Lyme and Associated Diseases Society, Lyme Disease Treatment Guidelines.
This article is also a great place to make comments about the current state of Lyme disease treatment in the US.
KarlaL
The Opinion Pages | OP-ED CONTRIBUTOR
Don’t Homogenize Health Care By SANDEEP JAUHARDEC. 10, 2014
IN American medicine today, "variation" has become a dirty word. Variation in the treatment of a medical condition is associated with wastefulness, lack of evidence and even capricious care. To minimize variation, insurers and medical specialty societies have banded together to produce a dizzying array of treatment guidelines for everything from asthma to diabetes, from urinary incontinence to gout.
At some level, this makes sense. Some types of variation are unwarranted, even deadly. For example, we know that ACE inhibitor drugs improve quality of life and survival in heart-failure patients, but only two-thirds of American physicians prescribe these drugs to such patients. A study by the National Committee for Quality Assurance, a nonprofit organization focused on health care, reported that 57,000 Americans die each year because the care they get is not based on the best available evidence.
But the effort to homogenize health care presumes that we always know which treatments are best and should be applied uniformly. Unfortunately, this is not the case. The evidence for most treatments in medicine remains weak. In the absence of good evidence recommending one treatment over another, trying to stamp out variation in care is irrational. . . .
Thanks for posting this (and so many of the other good things you post, too).
Yesterday, I saw this and hoped someone else would have the energy to pass it along. Glad you did.
Chilling questions, unsettling scenarios are certainly developing due to this "standardization" and cook-book / recipe manner of medical care. Ugh. Glad to see at least one doctor speak up.
Still, his essay examples were rather simplistic (maybe to save space) compared to the kinds of leeway required when treating the kinds of things ticks bring.
I think doctors may not being to comprehend the scope of what's really going on or what's really required for optimal patient care. Certainly those writing guidelines have no clue to the complexities. Nor care. -