Why I Don’t Adhere to Evidence Based Medical Care

8/13/13
 
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by John Goodman,

from NCPA,
8/12/13:

We are about to enter a world in which health insurers will only pay for procedures and drugs that are strictly evidenced-based. In fact we are about to enter a world in which doctors will be encouraged to reflexively practice evidence-based medicine for all patients ― regardless of who is paying the bill.

This will have consequences. Just about everything my doctor and I were doing the other day probably violates evidence-based guidelines, including ordering a blood test on an otherwise healthy patient.

But remember, every advance in medicine started with someone doing something out of the ordinary, something different, something no one else was doing.

If you insist on only employing therapies that are evidence-based, you will only get access to many useful therapies years — or perhaps decades — after other patients have befitted from them.

What about vitamin D? Actually there have been a number of trials with it and it looks like it’s good for you. Unfortunately, there is no evidence-based guideline for testing for vitamin D deficiency.

There have also been trials with DHEA and they are positive, but probably not sufficiently so for your insurer to pay for it and certainly not enough for your insurer to approve screening for DHEA deficiency.

There have been trials on vitamins as a whole and the results haven’t been good. This, despite the fact that Prof. Bruce Ames (University of California at Berkley) has found striking effects of vitamins in rodent studies.

What should insurance pay for? I don’t have a problem with evidence-based insurance. That’s probably a good way to keep premiums low and shield us from the cost of other people trying out every cockeyed claim that comes their way.

But it is advisable for each of us to have a Health Savings Account, so that we can use our own judgment and make our own choice’s when it appears in our interest to do so.

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