Evidence-Based Medical Care and Tests

It has been quite some time since I found something in the hospital dangers/medical care area worth a blog post. This post today I consider the most important one in the history of this blog.

Countless medical tests and routinely accepted medical procedures are performed every day in this country. In a number of cases, the only justification for them is what a doctor learned years ago in medical school or because some non-evidence based “hospital policy” requires them. The result is not only monetary but at times serious risks to a patient’s health and very survival.

Rather than try to list specific examples, please follow the link to the Choosing Wisely site. The Choosing Wisely site is an initiative of the ABIM Foundation: Advancing Medical Professionalism to Improve Health Care. It was created by the American Board of Internal Medicine. The foundation’s purpose as stated on the “About” page aims to promote conversations between clinicians and patients by helping patients choose care that is:

  • Supported by evidence
  • Not duplicative of other tests or procedures already received
  • Free from harm
  • Truly necessary

In response to this challenge, national organizations representing medical specialists asked their providers to “choose wisely” by identifying tests or procedures commonly used in their field whose necessity should be questioned and discussed. The resulting lists of “Things Providers and Patients Should Question” will spark discussion about the need—or lack thereof—for many frequently ordered tests or treatments.

As the caution on the “About” page of this link notes: “Choosing Wisely recommendations should not be used to establish coverage decisions or exclusions. Rather, they are meant to spur conversation about what is appropriate and necessary treatment. As each patient situation is unique, providers and patients should use the recommendations as guidelines to determine an appropriate treatment plan together.”

This blogger believes each patient has a responsibility to do everything possible to be fully informed about their own (and loved ones) health care. Only by taking advantage of the best currently available advice can this need by accomplished.

Review the “For Patients” list and read the information provided by Consumer Reports: Health. resources.  Do not be deterred by the “For Clinicians” title of the other list. Instead, download the 188 page PDF link in the right-hand column. Check this one out thoroughly as well. While it may include some technical terms, the basic content should be understandable.

Then, for specific recommendations that may apply, print out them out put into your personal health record file. Take them with you when you visit your doctor or find a hospital stay in your future. Checking back for changes/updates regularly is advisable as well.

For anyone who has spent a bit of time in a hospital, you may be surprised at some of the things that are done routinely such as being awakened every two hours. The consequent sleep deprivation may be dangerous for your help and according to the experts may not be necessary in all cases. Being forewarned about this kind of thing or other tests that are ordered allows you to have an intelligent conversation first with your doctor about the benefit and/or need.

Check it out!