I was reminded this morning of Brent James' comment about "well-documented massive variation in practice based on local medical myths". The reminder was an article in the July Consumer Report, Too much treatment? Aggressive medical care can lead to more pain with no gain, summarizing the 2008 Dartmouth Atlas of Health Care. Well worth reading in its entirety. (Thanks to e-Patient Dave for the heads up.)
Wider awareness of this data is long overdue. (I was not aware of it myself till I first started reading this blog, helped along by the Health Care Blog. Thanks, Paul!) It is scary to think much of medical care lacks any real scientific basis, but evidence- based medicine is no panacea itself. As the inventor of the term itself observed (I cannot remember his name) - there is compilation of the evidence, and then there is interpretation of the evidence to formulate a conclusion. The latter is still problematic.
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