Informed Decisions: Making Sense of It All
Most people will agree that technological innovations have led to great strides in helping sick people get well and in preventing illness in the first place. EBM encourages use of those new procedures that have been shown to be of most benefit to the majority of patients, and patient-centered care filters these practices in an attempt to provide the optimal care for each individual.
So, when we say that today's healthcare is patient-centered, evidence-based, and focused on improved health outcomes, it kind of makes us want to scratch our heads and say, "Well, hasn't it always been this way?" In a manner of speaking, yes, but in a much less organized and formalized system of care that was often limited by the experience of the individual physician and that did not benefit from the scientific analysis of best practices.
It is important to remember that the newest fields of modern medicine, which we'll define here to include laboratory medicine, radiological medicine (x-rays, MRIs, etc.), and pharmaceutical medicine, are still young and maturing. After decades of explosive growth and dramatically positive impacts on health outcomes, medical scientists have only just begun to effectively manage the explosion of knowledge that they have gained.
As healthcare has become a more routine and, in some cases, costlier part of our daily lives, the medical community has even greater incentive to standardize the lessons learned and how to apply those best practices to the individual patient. EBM and patient-centeredness are two of the yardsticks used by the medical community to measure the value of medical care, such as testing and treatments, and to verify their effectiveness in improving health outcomes.
In some respects, EBM and patient-centered care represent two ends of a spectrum. You and your healthcare provider must learn to balance EBM with patient-centered care. The conversation you have with your practitioner should evaluate options based on standardized guidelines and the proven benefits and harms, but also take into account everything from your personal and medical history to your philosophical and religious views, cultural background, personal risk tolerance, and the specific circumstances in which you are making your decisions. To help illustrate these concepts, we have gathered several real-world examples of laboratory tests along this spectrum in the following section, The Spectrum of Care.
Regardless of the particular situation, patients who are well-informed and educated about their own health and the related decisions they face have an advantage in ensuring that priorities are balanced to improve their personal health outcomes. Though the illustrations presented here vary according to the rigor of evidence, in each case the opportunity for involvement of the patient is vital. Moving forward, medicine will require more from patients in determining the course of their testing and treatments.