We have previously written here about the ramifications of the economic stimulus bills that became law in February 2009. Putting aside the economic and security consequences of adding to the nation’s debt, let’s focus on the $1.1 billion for a Comparative Effectiveness Research (CER) program, designed to determine which healthcare treatment options are most effective — and most cost-effective. According to CER supporters, an immediate benefit would be cost savings for government-funded insurance programs. By determining which treatments are most effective, the less effective — and often more expensive — options would (theoretically) no longer be covered by government insurance plans, saving taxpayers money. But as we all know, the devil will be in the details.
Norbert Gleicher, M.D., visiting professor at Yale University School of Medicine, and president and medical director of the Center for Human Reproduction in New York City, wrote in the 10/19/09 Wall Street Journal that “the idea of inserting a government panel between patients and physicians remains contentious and with good reason.” Relating a personal story, Dr. Gleicher said that he recommended HRT to his own mother, to address her risk of osteoporosis. After all, the medical literature of that time advocated HRT for reducing the risk of bone thinning. Happily, Gleicher’s mother’s long-standing doctor did not advise that she use HRT. This turned out to be lifesaving, as she was later diagnosed with breast cancer, a contraindication for HRT.
According to Gleicher, most published studies are written by academics with little practical experience, a policy that allows university-based doctors who have limited patient contact to determine “appropriate clinical care.” He also mentions the bias of medical journals’ policy of peer review, a system he believes is rarely free of conflicts and only rarely objective. Quoting Albert Einstein, Gleicher says: “A foolish faith in authority is the worst enemy of truth.”
After listening to an earnest young family practitioner, just three months out of residency, repeat the old saw “We need more studies before we recommend antioxidants,” it was refreshing to hear a wise, local general practitioner of many years standing remind me, “Speak with a doctor/medical student at the end of the first year in school. They have just completed their study of anatomy, physiology and biochemistry. Nutritional medicine makes sense to them at that point. The following three years, and subsequent internship and residency schools, teach doctors to push prescriptions and procedures.” In a nation overburdened with chronic illness related to unwise lifestyle choices, prescriptions and procedures do little to address obesity, diabetes, heart disease, arthritis and cancer.
Dr. Gleicher is right in saying, “Expert panels would only slow medical progress and delay rejection of false prophecies and dogmas.”