Over the past 25 years, a movement towards "evidence-based medicine has gained momentum, driven in part by doctors like Lee Biblo at the Medical College of Wisconsin, who used clinical guidelines to reduce some patients' length of stay by about 16 percent - a full day, the Milwaukee, Wis., Journal Sentinel
reports. "Yet by encouraging doctors to follow guidelines, rather than relying solely on their own training, experience and intuition, is Biblo endorsing cookbook medicine? Is he interfering with the doctor-patient relationship?"
The debate raises questions that the health overhaul legislation attempts to address. "Is it better to treat prostate cancer with surgery, radiation therapy or watchful waiting? If a patient opts for radiation therapy, what kind works best? Are Zetia and Vytorin more effective in preventing heart attacks and strokes than older and less expensive drugs?" the Journal Sentinel asks. "Doctors simply don't know - and the same holds for dozens and even hundreds of procedures and drugs in widespread use. Yet in a health care system that spends $1.6 trillion a year, less than one-tenth of 1% is spent on research to determine which treatments are most effective." The health overhaul attempts to prioritize so-called comparative effectiveness research with hundreds of millions of dollars, on top of a $1.1 billion stimulus investment (Bolton, 6/27).