Does Medicine Mirror Fashion?
Does Medicine Mirror Fashion?
NPR’s The Story featured two cardiologists who debated the use of stents to treat heart disease. In the mid 1990s, deploying stents to help keep arteries open was considered the silver bullet for heart patients. Now, there’s some controversy over their effectiveness, particularly given their high price tag. The debate will most likely accelerate as comparative effectiveness takes hold in the industry post health care reform.
Is the use of stents today much different than TMJ therapy 20 years ago, or tonsillectomies 30 years ago? I suspect medical treatment trends wax and wane like fashions. They rise in popularity and then gradually fall into disuse or disfavor as new cures de jour come on to the scene. But, unlike leisure suits or go-go boots, the long-term consequences of medical treatment trends are more profound than embarrassment. They range from simply unnecessary to very expensive to downright dangerous.
Doctors shouldn’t recommend a treatment because it’s popular or because health insurance will pay for it. Recommendations should be based on sound research. There should be proof the treatment works. There should be confidence the doctor is thinking about his patient’s health more than the health of his practice when considering options.
Americans may not agree with all aspects of the newly-passed health care reform legislation, but it’s hard to argue with measures demanding proof over popularity and quality over quantity. This is reform that leads to sensible care, controlled costs and discriminating health care consumers. Whether these consumers are also discriminating in their fashion taste remains open to debate.
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