Understanding the gap between best practices and actual practices

Challenges of getting data to health professionals

“We could accurately say, “Half of what physicians do is wrong,” or “Less than 20 percent of what physicians do has solid research to support it.”

The above quote is from an article published in Scientific American last week called “Health Care Myth Busters: Is There a High Degree of Scientific Certainty in Modern Medicine?” (March 25, 2011) written by two physicians, Sanjaya Kumar and David B. Nash. The article is an excerpt from their book  Demand Better! Revive Our Broken Health Care System (Second River Healthcare Press, March 2011).

The article is a great summary of the challenges of creating “evidence-based medicine,” particularly the difficulties of ensuring that health care professionals have the data they need to make good clinical decisions.

Some interesting stats from the article:

  • the number of published randomized, controlled trials had increased from an average of 509 annually between 1975 and 1980 to 8,636 annually from 1993 through 1997
  • physicians looking at the same thing will disagree with each other, or even with themselves, from 10 percent to 50 percent of the time during virtually every aspect of the medical-care process
  • give surgeons a written description of a surgical problem, and half of the group will recommend surgery, while the other half will not

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