Outcomes Matter
I do not believe a doctor should do something to or put something in a patient unless they either know the outcome or are trying to find out. Data matters. Experience matters. But curiosity matters the most.
Medicine is an art as well as a science. The practice of medicine and surgery is based on experience and science. In the past, a doctor’s personal experience often mattered the most in many treatments. With the tools available today, with which we can query the outcomes of any therapy, there is no excuse for ignorance around the effects of any drug, therapy, and/or surgical procedure. While this may seem like a high bar for doctors who are practicing in healthcare systems organized around volume and cost reduction, it is not. The key outcomes tool is in the hands of every patient and doctor: the portable personal computer called the smartphone.
Well-developed, easy-to-use outcomes tools are now available to all physicians. These tools can gauge the effect of any therapy using validated outcomes measurement questionnaires. Programs with onboard cameras can accurately measure the range of motion of joints, provide gait analysis, and assess leg and spine alignment. The tools can also measure mood, skin temperature, blood pressure, heart rates, and virtually any health care metric.
The days of a drug being released after having been tested on a few hundred or even a few thousand patients—and then never assessed again—should be over. Today any drug or implant, once approved for use after the initial safety and efficacy trials, should be subjected to ongoing post-market approval data collections. All physicians should be able to report their outcomes and experience with each type of treatment, without exception. Every time a drug or device is used, the data should be sent to a review organization, with ongoing patient outcomes sent in by the patients themselves. This can be achieved by automated programs querying patients on a regular basis.
All this requires is the ongoing curiosity of the doctor.
Every physician got into medical school by claiming to be interested in the welfare of patients, in quality research and treatment methods, and in improving health care. It is imperative to give them the tools they need, and institute robust systems to uphold their aspirations. Don’t you want to know if something about to be put into you actually works?
