On: The Case for Being a Medical Conservative .

Episode: N/A

Date: July 2019

Background: Physician and author.

Key Subjects:

• Appreciate the complexity of medical care.
  • Challenges of finding reliable evidence to support medical interventions.
  • Inherent uncertainty surrounding outcomes.
• Many medical techniques advocated by experts are not always beneficial or cost-effective.
  • Gains may only be incremental (compared to current alternative).
  • Gains may only be enjoyed by very few (only works in small % of cases).
  • Gains may come at a high cost (both in $ terms, as well as potential side effects).
  • Costs may not be visible to patients (absorbed by insurance, only surface in the long run).
  • Evidence of efficacy may not be reliable (bad research, sponsored research).
  • Evidence of efficacy may be ambiguous (conflicting data, difficulty of objective assessment).
• Danger of content (deep) expertise.
  • Medicine has become very specialized.
  • Danger that content experts may become (overly) enthusiastic of (new) interventions.
  • Focus on data to determine what has the potential to improve a person’s overall condition.
• Medical conservatism:
  • As science advances, consider the costs, economic, and in terms of actual patient outcomes.
  • Have an open discussion with the patient about the alternatives (including doing nothing).

Key Takeaways:

• -/-

Worth Listening:

7/10