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"...algorithms and treatment guidelines are based on prototypes. They are not substitutes for individual thinking. And they break down when cases are atypical or complex. It's critical to factor in that human biology is highly variable, that diseases have multiple presentations, that symptoms exist with a range of intensity and frequency, while algorithms and treatment guidelines are, of necessity, simplifications. It is impossible to standardize all care."
"This is precisely when you need the 'lone specialist who distills clinical data.'..."
"Note that I don't dismiss algorithms and treatment guidelines out-of-hand. Rather, I use them as a point of reference and consider how they may or may not reflect the person in front of me. But in the last few years, I've grown increasingly concerned that the promulgation of algorithms and guidelines make it all too easy for us to stop thinking, indeed, to stop leading in diagnosis and treatment, and make us passive followers."
- Jerome Groopman, author of How Doctors Think (Houghton Mifflin, 2007), writing on slate.com
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Groopman hits the nail on the head. The various guidelines dumb medicine down, and give it a sense of " Scientific Supreme Law". And lots of doctors are not very curious, so they go with the easiest way out. Saves time, makes money. My guess is that the evidence based guideline business is also paving the way for computerized diagnosis. If you feel like crap, its not their problem. Not evidence based.
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Thanks for posting this. It is so true: we are all different and respond differently to treatment options. I hear this point made in every support group meeting I go to. This would be a good point to make when refuting this latest guidelines assault by the neurologists.
Posts: 13116 | From San Francisco | Registered: May 2006
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Well, guidelines streamline medicine so that doctors can speed up the assembly line, handle more patients, and it pleases insurance companies. What more could you want?
Posts: 8430 | From Not available | Registered: Oct 2000
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