Changing the Evidence Model

by andy on January 30, 2009

David S. Jones, MD (Textbook of Functional Medicine):  “Our romance with ever newer and more expensive drugs, technology, and surgeries has not achieved what we have been led to expect”.  “It appears undeniable that patients receive a lower quality of care than would be expected considering the high level of practitioner training and the huge body of research now available”.
“In addition to prevention strategies, many complex, chronic diseases are very responsive to dietary and various lifestyle interventions.  But clinicians without these skills are literally at the mercy of the pharmaceutical industry.  Doctors are taught about drugs by agent of the pharmaceutical industry, which works hard to persuade them to select the newest and most expensive medications – even in the absence of scientific evidence that they are any better than older, less costly ones. Or, we would add, even in the presence of evidence that many non-drug interventions are therapeutically effective and significantly less expensive”.

National health expenditures:
Increased 69% between 1990 and 2000, to a per capita cost of $4,637, which is 68.5 % higher than our closest competitor (Germany) and more than 2 ½ times as much as the UK.

Halsted Holman, MD of Stanford Medical School editorialized in JAMA 2004:
Chronic disease is now the principal cause of disability and use of health services and consumes 78% of health expenditures.

Dr. Alan Feinstein, MD from the Department of Medicine, Yale University, in his article:
“Problems in the Evidence of Evidence-based Medicine, we are in the transitional stage of realizing that our tools of evidence are inadequate.

Dr. Richard Horton, MD editor-in-chief of The Lancet addressed this issue in an editorial titled, “The Precautionary Principle”:
Where the state of the health of the people is at stake, the risks can be so high and the cost of corrective action so great, the prevention is better than cure.  We must analyze the possible benefits and cost of action and inaction.
This short sighted approach to health care should give us all cause for serious concern, because it is perpetuating a system that is far too costly and increasingly ineffective for the prevention and management of chronic diseases.

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