Medicine Is An Art, Not A Science: Medical Myth Or Reality? – Forbes

The first installment of Dr. Robert Pearl’s “medical myth” series explored whether “More Health Care Is Better Health Care.”

Today’s article tackles this question: Is the practice of medicine more of an art or an applied science?

It’s a debate patients may not even know is taking place. But the way your primary care physician, surgeon or hospital answers this question may determine whether you live or die.

Doctors on the far “art” side of the spectrum maintain that every patient and physician is different. Therefore, they believe there is no one right way to treat a patient – labeling adherence to a common solution as “cookbook medicine.” They conclude that when two doctors approach the same problem in different ways, it’s simply a matter of each doctor finding their own best solution for the patient’s needs. They believe personal judgment and doctor’s intuition are keys to highly personalized care.

This point of view doesn’t fly with doctors who view medical care as an “applied science.” They disagree in large part with those who say there’s no one way to treat a patient. Most variations in care delivery, they argue, are relics from the days before sophisticated information technologies and advanced diagnostic tools. They rely on research and scientific evidence to shape guidelines for improving clinical outcomes. They believe in most cases, variation reflects out of date thinking and leads to poorer patient outcomes.

As with all worthwhile debates, both sides make valid points. But which side is saving more lives? Let’s examine three life-threatening conditions to help separate medical myth from reality:

US Navy 110308-N-7491B-039 Surgical technician...

For doctors and surgeons alike, is medical practice more of an art or an applied science? (Photo credit: Wikipedia)

Treating Patients With Stroke
The American Stroke Association (ASA) reports nearly 800,000 Americans suffer a stroke each year. It is the No. 4 cause of death in the U.S. and a leading cause of disability.

Recognizing that the clinical management of stroke patients varied greatly throughout the U.S., the ASA joined forces with the American Heart Association (AHA) to publish nationally accepted standards for testing and treatment.

Together, they found that when blood flow to the brain is blocked, every passing second increases the risk of impairment or death. They believe that following AHA/ASA guidelines could greatly reduce that risk, whereas taking a case-by-case approach greatly increases that risk.

A recent Journal of the American Medical Association (JAMA) article found that “implementation of a national quality improvement initiative” improved not only the timeliness of procedures, but also lowered rates of hemorrhaging and in-hospital deaths.

Further research shows the best hospitals are the ones using AHA/ASA recommendations to standardize admitting orders for stroke patients. These hospitals embedded procedures in a common electronic medical record (EMR), which is proven to lower rates of hospital-acquired pneumonia and death.

Simply put: Hospitals using a standardized approach are the ones lowering the chances of death and disability the most. Hospitals that allow physicians to base their admitting orders on personal preferences don’t fare so well – and neither do their patients.

Preventing Recurrence Of Heart Attacks

According to the American Heart Association, over 700,000 people in the U.S. have heart attacks each year. About 1 in 3 Americans with a first-time heart attack suffer a subsequent heart attack.

Research shows that administering beta-blockers, ACE inhibitors, aspirin and statins after a heart attack can substantially reduce the risk of future cardiovascular events.

The best physicians prescribe these medications more than 98 percent of the time, according to the National Committee for Quality Assurance (NCQA). It is easy to do, relatively inexpensive and linked to very few complications.

What Next?

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