Science Knows Best
September 26, 2003
There is a gap between the remarkable successes that science has scored in curing lab rats and the treatments developed for humans. But doctors often fail to pass on to patients the fruits of any discoveries. In other words, even when researchers parlay basic science into "best practices" -- treatments vetted by large clinical trials, the National Institutes of Health and groups such as the American Heart Association and American Diabetes Association -- the actual care for thousands of people falls short, says Sharon Begley.
This isn't about giving everyone the latest biotech drugs or other budget-busters. Doctors are failing to give long-acting medications to asthmatics who use short-acting ones a lot. They're not giving anti-platelet therapy to stroke patients. They're not urging patients with lower-back pain out of bed, says Begley.
These failures aren't just at the margins. Researchers with Rand, the think tank based in Santa Monica, Calif., reported:
- Some 76 percent of diabetics aren't getting routine hemoglobin screening (essential to spot looming complications such as kidney failure).
- Only 45 percent of heart-attack patients are on beta-blockers, which cut the risk of premature death.
These lapses, the Rand team concluded, "pose serious threats" to the health of the public."
Patients definitely bear some of the blame, for failing to make or keep appointments or to take prescribed drugs (though for many, the cost is prohibitive). But "a large part of the problem is the real resistance from physicians," says Dr. Sidney Smith, professor of medicine at the University of North Carolina, at Chapel Hill. To put it bluntly, many of these independent-minded souls don't like being told that science knows best, and that the way they've "always" done things is second-rate.
Source: Sharon Begley, "Too Many Patients Never Reap Benefits of Great Research," Wall Street Journal, September 26, 2003.
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