An interesting perspective of EBM

From: Gordon M. Goldman (obgyndoc@swbell.net)
Mon Dec 20 21:00:04 2004


The attached email was sent from our City/County Medical Society.

Interesting reading.

--
Gordon M. Goldman, M.D., FAOCG

Private Practice, St. Louis, Missouri

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MEDIA RELEASE For Immediate Release Monday, December 13, 2004

====================================== Citizens' Council on Health Care 1954 University Ave. W., Suite 8 St. Paul, MN 55104 http://www.cchconline.org ====================================== FMI: Twila Brase, RN, President PHONE: 651-646-8935 ======================================

WAKE-UP CALL: Technocrats are Taking Over the Practice of Medicine

(St. Paul, Minnesota) - A report meant to challenge current thinking in health care reform was released today by Citizens' Council on Health Care (CCHC).

Extensively documented, the report: "How Technocrats are Taking Over the Practice of Medicine: A Wake-up Call to the American People," shines a bright light of openness on the terms "evidence-based medicine" and "best practices," including the purposes of proponents and the concerns of critics.

"The public needs to understand that evidence-based medicine is an attack on the patient-doctor relationship. EBM is not individualized care. It is group-think medicine," says Twila Brase, president of CCHC and author of the report.

Noting the recent and growing inclusion of these terms in state and federal law, Ms. Brase told news reporters last Thursday at an special press briefing:

"If evidence-based medicine is not understood for what it is, managed care will use it to solidify control over medical decisions and the practice of medicine. Managed care will become the law of the land."

CCHC stresses the following five points:

1) The term "evidence-based medicine" (EBM) cannot be taken at face value. EBM is managed care. Same game, different name.

2) Science, the purported foundation of EBM, is not incontestable. In research, there are subjective choices all along the road to creating the "evidence" of EBM.

3) Practice guidelines, used to implement EBM, have significant problems. These include out-of-date, biased, conflicting with each other, lack of individualization, and single-disease focus.

4) Under EBM, practice guidelines are becoming treatment mandates. Financial consequences are increasingly a possibility for doctors who do not follow guidelines issued by health plans or government. Computer systems to track and report physician adherence are being established.

5) Patient harm can result from EBM, and its treatment mandates. Practice guidelines are written based on data collected from medical records of many patients. They do not focus on the care, or the unique circumstances and physiology, of individual patients. And, as has been reported in England, they can be used to implement health care rationing.

"Control over medical decisions is being shifted from doctors to data crunchers; from professionals at the bedside to bureaucrats in big offices," says Ms. Brase.

"The public should not be fooled by the nifty-sounding names. Evidence-based medicine is managed care masquerading as science,"

The CCHC report can be viewed at: http://www.cchconline.org/pdfreport/

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Twila Brase RN, PHN ---------------------------------- President ---------------------------------- Citizens' Council on Health Care 1954 University Ave.W., Suite 8 St. Paul, MN 55104 651-646-8935 phone 651-646-0100 fax http://www.cchconline.org

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