Kevin Pho, M.D.
New Hampshire-based Kevin Pho, M.D., believes most physicians – especially family docs, like himself – will welcome comparative effectiveness research, but drug and device companies “will be resistant.” Specialists, too, might balk because, he believes, some testing and procedures they do might not be “deemed necessary.”

In an interview for Progress Magazine, Pho told me he currently pays for a service providing online, peer-reviewed, evidence-based data to help him make everyday decisions on patient care. He, for one, will be quite pleased when he can access a larger, free service.

“Physicians need an authoritative source of unbiased data, untainted by the influence of drug companies and device manufacturers,” Pho wrote in a recent post on his blog, www.kevinmd.com/blog/.

Will the publication of data collected through CER result in the rationing of care? Maybe, Pho says, but that might not be such a bad thing.  

There's no reason to assume changing care will be equal to reducing care. If we know what works and what doesn’t, for whom and under what conditions, he says, change will benefit the patient, not hurt him or her. 

Pho believes advertising agencies and other media have sold patients the myth that, when it comes to health care, #1/ more is better, and  #2/ the newest care is always best.  

Not so fast, says Pho.  A number of important, large-scale recent studies (see Dartmouth Atlas 2008) have shown that sometimes more care can be harmful.

As for new drugs, don’t forget that, just because they’re on the market, there’s no guarantee they will work for you.

 “We need to break that myth,” he says. “Older, more established treatments may actually be better. It’s a difficult concept for some patients to grasp.”

Think Eastern medicine and herbal remedies. Maybe your grandmother was right about the benefits of cod liver oil. And, and OTC drug is a whole lot cheaper than some of the fancy drugs you see advertised on television. If it works, why not use it?  

Think of all the drugs that have been taken off the market in recent years because they were either ineffective or potentially harmful.  

“There’s no point paying for treatments you know won’t work,” he said, in the interview.

“Realistically, to control health care costs, the medical community will have to make some big decisions, and the best way is to make unbiased decisions with unbiased data and recommendations,” he wrote on his blog.

Is that rationing? Or, just making good use of experience?

To read more of Kevin Pho’s comments on health care, go to his blog, www.kevinmd.com/blog/



08/19/2009 20:24

Glad you're doing this healthcare series, Paula!


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