My name is Dr. Todd Feinman, and I have dedicated my career over the last 12 years trying to get consumers to use evidence every time they are given a recommendation or hear a claim from a doctor (or any expert.) As a medical director and hospital-based physician, I enjoyed witnessing how modern medicine could save lives, cure illnesses, and decrease suffering. At the same time, I also saw too many patients get the wrong treatment or an unnecessary treatment because both the patient and doctor did not rely on outcome data (evidence) that proves what is the right therapy for each unique patient.
Raise your hand if you have ever asked your doctor for evidence after they gave you a recommendation of any sort. Did you ask how many people were given that therapy and what % had a good or bad outcome? I am assuming very few of you are raising your hand right now.
Now raise your hand if you have ever used evidence to buy a car (i.e. Carfax) or buy a mutual fund (i.e. E-Trade) or buy an appliance (i.e. Consumer Reports) or bought a book (i.e. Amazon Reviews) or reserved a hotel (i.e. Trip Advisor). I bet most of you are raising your hand.
The data and reviews from these sites are very similar to the evidence you would want to see to make any medical decision. So why do we use evidence when we buy cars, houses, TV’s and other consumer goods but we never ask for the same evidence when our doctors give us drugs or put us under anesthesia and operate on us?
After interviewing thousands of patients over the years, I know the answer to that question. Most patients trust that their doctors are ordering the “best” therapy for them, and/or patients are reluctant or afraid to question their doctor. Also, some patients are “too busy” to review evidence. Fear, trust, and laziness increase the chances that a patient will get the wrong treatment.
At this point you should be asking yourself these questions: Does my doctor order the best therapy based on a complete review of ALL the relevant outcome data that is available? Is my doctor ordering a therapy that the insurance companies force him/her to order, or ordering a therapy that is considered “standard of care”? Or is my doctor recommending a surgery because they are a surgeon? Do you end up getting a treatment that depends more on your insurance status, where you live or the time of day you were seen in the ER?
These questions are critical given that thousands of patients every year get the wrong diagnosis, unnecessary medication or surgery, or just get the wrong therapy. Why would anyone take a chance given that almost every treatment had side effects; some known and some unknown? Why don’t we demand the data that proves that you are getting the therapy that has the highest probability of a good outcome and the lowest probability of a bad outcome?
Going forward, this blog will cover the following topics and questions:
- What is evidence and how to use it to make informed decisions?
- What do doctors use to make recommendations (i.e. Guidelines, formularies, etc)?
- Why don’t most doctors use evidence/data to make recommendations?
- Real stories of patients who have used evidence to get better healthcare.
Go to www.showmetheevidence.com/videos to watch videos about the above topics, and learn why we say “Inside every patient there is a doctor, if they have evidence.”