An editorial by cardiologist Sandeep Jauhar published in the New York Times in December presents a persuasive argument for balancing evidence-based care with human judgment so as to provide “personalized” care, not “homogenized” care. Eliminating variations in practice is an important goal but is an ongoing endeavor, given the ever-changing nature of the evidence.
In “Don’t Homogenize Health Care,” Dr. Jauhar asserts that presenting the evidence can’t be the be-all end-all for medical decisions. For example, for brand new treatment methods, there is no evidence yet. For others, the evidence is outdated. “What is in vogue today is often discarded tomorrow,” Jauhar says, noting that beta blockers for non-cardiac surgical patients were routinely recommended, but are now understood to increase the risk of stroke for some patients. And patient preference is also an important input to the decision-making process, and may countermand standard practice.
As American College of Cardiology President Patrick T. O’Gara noted in his defense of a reversal of a major recommendation for heart attack treatment: “Science is not static but rather constantly evolving.”
“Neither the old approach, in which seemingly every patient was treated differently, nor the new one, where we try to treat them all the same, has worked well. Medicine needs another way,” Jauhar writes. In 2015, healthcare could move in a number of directions to foster personalized patient care with better clinical outcomes—including genomic research.
Here at QPID Health we’ve committed to an evolving platform that can change as clinical knowledge broadens. We were pleased to hear such a compelling argument for our design principles from Dr. Jauhar.