On: The Case for Being a Medical Conservative .
Date: July 2019
Background: Physician and author.
- 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).