Friday, November 4, 2011

Amerling on the Danger of Practice Guidlines

Dr. Richard Amerling gives a detailed analysis of the problems with so-called "practice guidelines".

The many problems he identifies include:
1) They wrongly promote "cookbook" care that glosses over individual variations in patients.
2) They are too often based on faulty or biased data.
3) They are too often obsolete by the time they are codified.
4) If current political trends continue, physicians can be held accountable for failing to adhere to these guidelines, even if that is the correct care for their particular patient.
In short, they remove the practicing physicians mind from clinical care -- the most essential aspect of high-quality medicine. Instead, they create the "illusion of knowledge" while stifling genuine innovation. Interestingly enough, he shows how faulty guidelines can result of both inappropriate undertreatment and inappropriate overtreatment of patients.

Dr. Amerling illustrates these points with real-world examples from his specialty of nephrology. His summary of how such practice guidelines are playing out in Europe is especially disturbing (timestamp 26:15).

Watch the full video at: "Practice Guidelines: More Harm Than Good?"

More information on Dr. Amerling:
Richard Amerling, M.D. is a nephrologist practicing in New York City. He is an Associate Professor of clinical medicine at Albert Einstein College of Medicine in New York, and the Director of Outpatient Dialysis at the Beth Israel Medical Center. Dr. Amerling studied medicine at the Catholic University of Louvain in Belgium, graduating cum laude in 1981. He completed a medical residency at the New York Hospital Queens and a nephrology fellowship at the Hospital of the University of Pennsylvania. He has written and lectured extensively on health care issues and is a Director of the Association of American Physicians and Surgeons. Dr. Amerling is the author of the Physicians' Declaration of Independence.