Evidence-based medicine (EBM) is an approach to medical care which claims that the best way to decide on medical treatments and/or practices is to continually defer to the best scientific evidence available. EBM is primarily meant to be used as a decision-making model when analyzing the best form of care for the patient. This approach supposedly integrates firsthand clinical experience with outside scientific evidence from clinical trials in order to craft the best available pool of information.
The merits or dangers of evidence-based medicine notwithstanding, a recent study published on the website of the journal Health Affairs suggests that additional education on the consumer front is necessary before more Americans will accept the practice. The study was conducted between August of 2006 and December of 2007 and collected data based on popular consumer-oriented methods such as focus groups, online surveys and interviews. The team conducting the research project also interviewed a number of professionals, specifically forty employer intermediaries like human resources staff.
Since the recent healthcare reform law includes encouragement of evidence-based medicine, the release of this study is particularly timely. The majority of the participants in the focus groups stated a belief that EBM would impinge upon the patient’s freedom to choose treatment and result in medical practices becoming artificially rigid and unresponsive to patient needs. These participants wanted the freedom to make choices about their healthcare using both their physician’s judgment and their own about quality of care.
One notable participant even went on record as saying that evidence-based medicine was a method of protecting doctors from medical malpractice liability. Obviously, such a negative denial indicates that consumer education must become a significant priority for advocates of EMB. According to Dr. Kristin L. Carman, who is the co-director of health policy and research at the American Institutes of Research, the study demonstrated the need for consumer education to fill the gaps between EMB and consumer knowledge. The study also gave cause for optimism, however. A minority of participants understood and accepted the basic tenets of EBM and expressed a willingness to increase their level of participation with their own care.
The participants in the survey also revealed an interesting aspect: just 47% of those surveyed agreed that people should pay less out-of-pocket for the most effective medical treatments. A significant minority, 33%, also believed that the better a medical treatment is, the more it should cost. Importantly, an astounding 55% of respondents stated that they did not actively participate in their own medical care. For example, these 55% said that they never took notes during medical appointments, and 28% said that they did not come prepared with a list of questions to ask their doctor.