Are You Getting Effective Medical Care?

As a patient, one must always question whether you are receiving effective medical care. But as a lay person, how would you know?
The Institute of Medicine's Crossing the Quality Chasm report defines effectiveness as "care that is based on the use of systematically acquired evidence to determine whether an intervention, such as preventive service, diagnostic test, or therapy, produces better outcomes than alternatives, including the alternative of doing nothing". This definition serves as the foundation for evidence-based medicine.
I refer to evidence-based medicine as one of my 8-points of change for healthcare.It is one of the backbones for healthcare stewardship. What does it mean to receive evidence-based medicine?
Evidence-based medicine is the melding of three critical factors:
1. Best research evidence derived from laboratory experiments, clinical trials, epidemiological research, and outcomes research.
2. Clinical expertise through which the clinician uses his clinical skills and experience to rapidly evaluate each patient's unique health state, to make a diagnosis, and to recommend treatments based on knowledge of the respective risks and benefits.
3. Patient values which refers to each patient's unique preferences, concerns and expectations that are part of each clinical encounter.
The lay person may ask the question: What care is right? The clinician must be able to explain in lay terms the above three criteria in order to ensure that the care the patient is about to receive will be effective.
This is a new concept for many patients. It is new because these types of medical care help patients learn to manage their own health. It forces a dialogue between the patient and clinician in order to come to an agreement on what care is right for the patient. This is healthcare stewardship. This is what I use with my patients.
Is your doctor using it with you?
Dr. Dale