Partnership to Improve Patient Care

Partnership to Improve Patient Care (PIPC) chairman, Tony Coelho, recently delivered a speech on patient centered comparative effectiveness research (CER) in front of fifty specialty doctors from around the country, among others, at the Alliance for Specialty Medicine’s (ASM) “Capitol Hill Advocacy Conference.” The conference took place just a day before the specialty doctors met w

A new Health Affairs article concludes, based on focus groups and interviews, that "consumers will revolt if evidence-based efforts are perceived as rationing or as a way to deny them needed treatment."

You don't need to look any further than public reaction to the U.S. Preventive Service Task Force's updated recommendations on mammography screening to see the proof of this.
 
How should policy-makers react? Should they conclude that consumers, and even more so, patients, cannot be relied on to make evidence-based decisions, and therefore these decisions need to be made for them? Or should they conclude that evidence-based models of medical care and health delivery need to be carefully constructed so they have the trust and support of patients and consumers?

A recent op-ed in the Wall Street Journal by Dr. Leonard Zwelling, illustrates why treatment decisions must stay between a patient and their doctor and reinforces the importance of the comparative effectiveness research (CER) language included in the recently passed Patient Protection and Affordable Care Act.

Zwelling, an oncologist, explains the challenges of using CER to set rigid national policy requirements. He highlights how cancer care is continually evolving in that it allows doctors to better address the individual needs of cancer patients whose bodies react to their forms of cancers in different ways than those of other patients:

A recent Wall Street Journal article about the use of stent procedures in the medical community and the reaction to it by blogger Burt Cohen, offers another illustration of the complexities of comparative research, and again shows why results should be used to inform doctors and patients, but not to impose broad “one size fits all” prescriptions that do not reflect the complexities of the science or the differences in individual patients.

A few days ago, I posted about what I saw as one of the key lessons from the controversy over the new U.S. Preventive Services Task Force’s (USPSTF) mammography guidelines, namely, that expert panels can sometimes come to different conclusions based on the same evidence.