A good piece on the need for rigorous evaluation of what treatments work and which do not. As always, performance management approaches are not popular and tend to be relatively unfunded compared to the new and exciting. Quote:
Research like this takes more than grant money. For starters, it takes a research infrastructure that monitors what standard practice is — data on what’s actually happening across the country. Because of Medicare, we have a clear view for patients age 65 and older, but it’s a lot cloudier for those under 65. Basic questions like how common annual physical exams are and what testing is part of them are unanswerable.
It also takes a research culture that promotes a healthy skepticism toward standard medical practice. That requires physician researchers who know what standard practice is, have the imagination to question it and the skills to study it. These doctors need training that’s not yet part of any medical school curriculum; they need mentoring of senior researchers; and they need some assurance that investigating accepted treatments can be a viable option, instead of career suicide.