More about EBM dangers…

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Dr. Michael J. O’Connell, New Hampshire commented that anyone who has ever perused just a small sampling of available “solid” medical research will note one glaring reality—most scientific studies come to no conclusion except that the difference a treatment makes is either nonexistent, or so small as to be only ‘proven’ significant through statistical wizardry, and not even close to being startling enough to revolutionize the treatment method that’s already provided.

As I have blogged many times, Evidence Based Medicine (EBM) as preached by the federal government and eagerly embraced by the insurance industry provides ‘average results, sometimes averages of many average results (so called meta analysis), for one single treatment vs. another, or one single treatment vs. no treatment at all.  What is not included in EBM is a prescription for the best treatment of the unfortunate patient sitting or lying in front of the doctor.  RCTs (random controlled trials) provide at best a glimpse of what may generally be among the treatments to consider, but cannot by its very nature provide the definitive answer to a clinician’s immediate problem.

A great example of the difference between EBM and real life medicine…..Tiger Woods, once far and away the premier professional golfer, before he suffered recurrent knee and then back injuries, gave in to EBM and elected to have a minimally invasive partial discectomy peEBM more dangersrformed through a Band-Aid incision, using a long tube (scope) through which his protruding disc was zapped or extracted.  The data supporting this approach has rapidly transformed this technique from that of ‘experimental’ to the ‘standard of care’ for such back problems, all due to the positive outcomes demonstrated by EBM.  The technique is even approved by Medicare, the typically stingy bellwether for other insurance companies to follow.  Woods even skipped his favorite tournament this year (the Masters) to allow for total recuperation, far more recuperation than necessary according to EBM, so as to be sure of being in top form.  The result was a flame out in the British Open during which he suffered continuously from spine pain and back spasms, and today a pullout from the PGA sponsored Bridgestone Invitational tournament for same.  So much for EBM.

Does anyone see the danger here?  This incessant reliance on crunched sterile data and less on the art of medicine and logical reasoning, is potentially leading to more unnecessary if not frivolous medicine due to the faux legitimization by EBM.

About Dr. Michael J. O'Connell, New Hampshire
Dr. Michael J. O'Connell of Barrington, New Hampshire, has forged a distinguished career spanning over three decades, as entrepreneur, physician, businessman, philanthropist and healthcare consultant. As former owner, administrator and CEO of a 225+ employee multi-specialty medical practice, Dr. O'Connell has dedicated his entire professional life to helping patients with family medicine and especially those experiencing chronic pain and all aspects of addiction. Since selling his family of healthcare businesses, he has never once contemplated retirement despite his rich and fulfilling journey, but instead has turned his focus to consulting in an industry starved for courage and creativity. Having weathered many political, technological and legal challenges, there is hardly a storm he has not confronted, a tempest he has not quelled, an urgent need he has not met. While the talking heads and self-proclaimed experts in the field have assumed the conventions and standards of the times, Dr. O'Connell does not believe in merely reflecting the herd mentality, but rather in leading the charge. Eschewing political correctness, Dr. O'Connell says and does what needs saying and doing, and not what the mindless masses expect. In addition to the continual education afforded by his variegated life experiences, Dr O'Connell earned his BS in Biochemistry at the University of NH in 1975, his Medical Degree from Dartmouth College in 1981, interned at Walter Reed Medical Center in 1982, Residency/Fellowship at UCSF in1986, and finished his Masters in Healthcare Administration at UNH in 1995. Dr. O’Connell enjoys many outdoor activities, including rock climbing, snowboarding, hiking, and golf. Through the decades Dr. O'Connell has supported many non-profit charities to include the St. Charles Home in Rochester NH, the Tri City VNA and Hospice, Hyder House, and Cocheco Valley Humane Society. To the latter organization alone Dr. O'Connell has donated over $180,000 and pledged another $250,000 in the “Bring-Us-Home” campaign for a new building. His “Matching Donations Christmas drive” has generated over $175,000 in charitable giving from the community. In addition Dr. O'Connell has participated in many dozens of other volunteer and donation efforts locally as well as in Africa and the Dominican Republic. For a listing of how I gave back to the community during my career and continue to do see:

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