"You Mean My Treatment ISN'T Based on Evidence?": The Best of the Weekend

by Tim Foley

categories: Doctors and Nurses, State and Local Efforts

Published September 13, 2009 @ 11:13PM PT

Every weekend, I present the three articles or videos that best enhanced my own understanding of the myriad issues that go into the general umbrella of health care reform. While most reports this weekend were focused on political strategy, shades of grey, and exactly how pompous Sen. Kent Conrad can make himself sound on television, there was also plenty of nuanced, thoughtful analysis, particularly on how we can improve the quality of the care we receive.

1.) Health Care Policy and Marketplace Review, “What Voters Really Think About Evidence-Based Care”

I don’t always see eye-to-eye with Bob Laszewski, but he knows his stuff and has an uncanny ability to cut through the bull and focus on what will really reduce costs and improve quality. His commentary on the Campaign for Effective Quality’s recently-released poll of California voters about their attitudes towards "evidence-based medicine" -- the notion that treatment options should be grounded in the latest scientific evidence and not just “Well, this is how we’ve always done it” -- is nearly as insightful as the survey results themselves.

The bad news is that patients think their health care treatment is generally evidence-based even though that assumption is highly questionable. The good news is that patients want it to be evidence-based.

At a time when we hear anecdotal evidence, particularly from town hall meetings, that people don't want any "interference" between them and their doctors they do seem to appreciate the need to get all of the facts when making a treatment decision.

Read the whole blog post on Health Care Policy and Marketplace Review.

2.) Boston Globe, “Vermont tests team approach for aiding chronically ill”

I’ve mentioned the “medical home” model of delivering care a few times. Since the bills moving in Congress would include more pilot programs to test out the medical home in Medicare and the public option would do likewise, it’s worth seeing how we’re implementing them in a few areas -- including Vermont -- today. A lot of people think the notion of having one doctor as a “home base” to coordinate all specialist care sounds uncomfortably close to managed care. In practice, however, it’s almost the exact opposite experience.

But when [diabetes patient Rita Pinard’s] blood sugar shot up in January, her doctor took more aggressive action, turning her over to a nurse, a dietician, and a diabetes educator who nagged and encouraged her to try to control her disease.

The extra help is part of a state effort to improve care and reduce costs for the chronically ill in Vermont. Under the approach, primary care doctors get extra money to put together teams to treat people with illnesses such as diabetes, asthma, and heart disease. They get bonuses if their patients show progress.

This coordinated approach, called “medical homes,’’ is being tried in Pennsylvania, Wisconsin, Maryland, and other states, and Congress is considering adopting it nationwide as part of the health care overhaul being debated in Washington.

Read the whole article on Boston.com

3.) NY Times, “In Health Care Battle, a Truce on Abortion”

In writing about this weekend’s anti-big-government protests in Washington DC, Matt Yglesias noted that the mood seemed to be as much anti-abortion as anti-health reform. He makes the observation, “Except for the fact that the health reform plans in congress wouldn’t actually do this. The anti-abortion side, in other words, already won this argument. Except nobody told them.” Actually, it’s more remarkable than that. As NY Times “Beliefs” columnist Peter Steinfels shows, health care reform has given rise to a fragile and remarkable between pro-choice and pro-life communities -- but one that could fall apart at any time.

Administration foes, like the National Right to Life Committee or the Catholic League for Religious and Civil Rights, were quick to declare that the president could not possibly mean what he said [when he said no federal dollars will be used to fund abortions].

But others, like officials of the United States Conference of Catholic Bishops and some religious leaders with concerns about abortion, welcomed his words. When it comes to health care overhaul, a surprising number of people on both sides of the abortion war have declared a limited truce.

The key words are “abortion neutral.”

Read the whole article on NYTimes.com

(Photo credit: http://www.flickr.com/photos/thenationalguard/ / CC BY 2.0 )