Healthcare decisions need to be based ‘primarily’, on sound scientific and clinical evidence. Unfortunately, this evidence is all to often ignored.
“It’s often difficult to make someone understand something when their income depends on their not understanding it.” – Mark Fendrick
If we don’t have ‘evidence based medicine’, you may recognise the alternatives. BMJ
- Eminence based – experience, is worth any amount of evidence. “making the same mistakes with increasing confidence over an impressive number of years.”
- Vehemence based – speak loudly and with authority.
- Eloquence based – the carnation, silk tie, ‘silver’ tongue and verbal eloquence.
- Providence based – when in doubt do nothing. If the practitioner has no idea what to do, the decision may be best left in the hands of the Almighty.
- Nervousness based – defensive approach ‘do everything to avoid litigation and hope it works’
Professor N Waugh (2006) added:
- Propaganda based – the drug company says.
- Pressure based – people want.
Clinical and Cost effectiveness
The requirement for proof of clinical effectiveness ‘should’ be a no brainer. Then the only difficulty should be when having to make decisions based on the cost effectiveness of a range of clinically effective interventions.
Is it, a disgrace that millions are wasted on Clinically and Cost ‘ineffective’ interventions? Then, there’s no money to ensure interventions which do work, are received by all those who would benefit!
Why? Because of the alternatives to Evidence Based Medicine?
Dr Jonnie McCrea
drjonathanmccrea 