In December we posted about practice variation and shared decision making (SDM), a field of research originated at Dartmouth decades ago and best known as publisher of the Dartmouth Atlas, which describes the amazing amount of unexplained variation in how many doctors prescribe what, in different areas of the country. For me personally this has been one of the most stunning discoveries as I’ve learned about healthcare: the evidence shows that a lot of medical decisions are simply not made scientifically by physicians. (See the December post for details.)
How can this be? Some cynics say hospitals and doctors are all driven by money, but if that were the case, we wouldn’t see some doctors prescribing things seven times less than others, would we?? But we do. (There’s nothing data to give a sense of what’s actually going on.)
Last night the CBS Evening News had a great short segment about the latest Dartmouth Atlas report (PDF, 11MB(!)). See how compellingly the data tell the story: (There’s a 30 second commercial at the start)
Appearing in the video are FIMDM president Mike Barry, and Kate Clay, Program Director of Dartmouth’s Center for Shared Decision Making.
I love concise visual depictions like this, but evening news sound bites are necessarily limited. There’s much more data in the nice interactive data graphics at DartmouthAtlas.org.
The practice variation topic links up with the dissemination of decision aids aiming to help patients choose between medical treatment options. Please visit the http://www.thedecisionaidcollection.nl site and share it with others. It is a multilingual comprehensive collection of decision aids to empower mankind.