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- W2136052020 abstract "Throughout this collection of essays, the Institute of Medicine and the Agency for Healthcare Research and Quality have identified an issue whose importance and nuances we are only beginning to appreciate. Although medicine has long claimed to be rooted in science, actual clinical care has often had only a limited scientific basis, resulting in inexplicably wide variations of care (Wennberg 1996). The past few years have witnessed a marked interest in evidence-based medicine (EBM), stemming from several concerns. First, decades of double-digit health care inflation led to a recognition that enormous amounts of money have been wasted on interventions with little proven value. Health plans facing pressures to keep premiums down and profits up have moved aggressively to curb wasteful practices such as excessive hospitalizations and needless surgeries. The ruling norm under lavish insurance—“If it might help and probably won’t harm, do it”—has given way to a leaner norm: “Don’t do it, unless you can demonstrate its value.” Under this new rule even common, widely accepted clinical routines have met coverage denials, and irate providers are scrambling to gather the kind of data necessary to document the value of their care (Morreim 1994). Second, the more forward-looking health plans aim, not just to cut costs, but to render care more rational. In many cases physicians’ clinical routines are based not so much on empirical evidence as on local" @default.
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- W2136052020 date "2001-04-01" @default.
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- W2136052020 title "From the Clinics to the Courts: The Role Evidence Should Play in Litigating Medical Care" @default.
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- W2136052020 doi "https://doi.org/10.1215/03616878-26-2-409" @default.
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