Sunday, February 15, 2009

NYTimes: "U.S. to Study Effectiveness of Treatments"

After many, many billions of dollars and uncertainty around evidence, the new stimulus bill will provide $1.1 billion dollars to study the effectiveness of various medical treatments.

From my vantage point at the medical school, I know that we a) spend an inordinately large amount of money on healthcare in this country without b) a clear sense of what works and what doesn't. The physicians in the course spend hours discussing what should be taught, what are the benchmarks, and what the students will be expected to do in both clerkships and residency. It's been an eye-opening experience for me to see how little consensus surrounds certain disease management and treatments among different medical professionals. Our healthcare system is quite inefficient, and I'm grateful that we will finally have some resources to potentially streamline.

However, one thing that irked me about the article was this:
In addition, Republican lawmakers and conservative commentators complained that the legislation would allow the federal government to intrude in a person’s health care by enforcing clinical guidelines and treatment protocols.

I'm sorry, how is enforcing clinical guidelines and treatment protocols a negative thing? Wouldn't people want to know with some general certainty that the pharmaceutical or surgery or therapy that they were spending money on or enduring was actually working?

I do understand the concern over care rationing; I don't know enough about these issues to come down solidly on a single-payer versus market-based versus whatever-else-is-out-there systems. However, with an increasing number of studies emerging about how beta-blockers are less effective as a treatment for heart failure in African-American patients than compared to Caucasians, or how multi-vitamins do jack-squat in preventing heart disease or cancer in post-menopausal women, I think that a lot more research needs to be done to ensure that what we are doing in health care makes a (positive) difference at all.

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