Archive for November, 2009
Kent Bottles: David Eddy Delivers Controversial Reinertsen Lecture About Future of Evidence-based Medicine
At ICSI, we pride ourselves on our evidence-based medicine guidelines. Starting in 1993 under the guidance of President Gordon Mosser, ICSI has developed a global reputation for excellence in providing guidelines that physicians follow and that help improve the care of patients. We proudly check the stats from http://www.icsi.org that show ICSI guidelines are being downloaded and used by clinicians from all over the world. We believe we know guidelines, and fervently believe in the work we do.
Several months ago, the insertion of a few sentences, perhaps not crafted as well as desired, but innocuous to most of us, resulted in a firestorm of public furor. The wish to provide reimbursement for the time a physician/health care provider provides consultation with a patient and family regarding end of life issues quickly became the basis for the well-known if not notorious (depending on your perspective) “death panels.” Pundits, commentators, little old ladies, ministers, for heaven’s sake, almost all venues raised a hue and cry against the evil notion being perpetuated upon our citizens by the inhumane, impersonal, autocratic bureaucrats and health care world.
My twitter buddy and former summer ICSI intern @agrey (Ashley Grey) invited me to be on a panel for an open forum titled “Health Care Reform 101.” The target audience for the event that was held in the Mayo Auditorium at the University of Minnesota was undergraduate and graduate students. Ashley introduced the topic by stating that only one in four young people between the ages of 18 and 24 are engaged in this timely topic for all Americans.
Occasionally, an event occurs which despite my best intellectual efforts, creeps into my consciousness and prohibits me from ignoring it. As a scientist at heart (at least that’s what my medical training tried to impart), it was my objectivity, my ability to rise above the fray, to remove my emotions from the discussion that were encouraged and valued. Often I would hear of the need to remove my personal feelings and involvement when engaging my patients to ensure that I was not “sucked in” to their personal issues.
Maybe it’s due to the Halloween time of year, but I want to focus on The Good, The Bad & The Ugly of Twitter & Texting. Anyone who has followed me on this blog or Twitter knows that social media is an important tool that I use to keep up to date in my field, network, and inform followers about ICSI educational activities.
The complexity confronting us in health care reform is beyond the capacity most of us have for dealing with issues. In a book entitled How We Decide, Jonah Lehrer compares the human’s prefrontal cortex function to that of a computer’s microprocessor—with one caveat—it’s not a very good one. When confronted with more than 4-5 incoming pieces of information, it is incapable of managing the information in a functional manner. Thus we strive for simplification, and hope to prioritize to allow us to feel at least a bit competent in dealing with the multiple challenges we face daily in health care.