Introduction
The article presents two cases, both illustrating deviations from evidence-based protocols. In the first story, the patient with chest pain refused a coronary stent implant, which was proposed by the doctor. Another doctor told him that the stent would not be useful, and the final treatment plan involving diet and exercise. This plan is less invasive and costly than the original suggestion. In the second story, doctors implanted a stent on a patient who had trouble breathing, although his symptoms were due to lung tissue scarring. The procedure delayed his lung transplant surgery, and the patient died, which is why the stent was a bad idea for this patient.
Main body
The prescription of ineffective treatments by doctors is rather prevalent in the United States. For example, doctors may prescribe ineffective therapies because they lack knowledge about their inefficiency or because patients demand these treatments. At the same time, innovative and potentially effective treatments are not always available because they are stuck in the testing process. The 21st Century Cures Act lowers evidence standards for new drugs and medical devices.
The $3.5 billion sums required for this bill come from public health funding, which may influence patient outcomes in terms of disease prevention, education, and healthcare access. However, the bill will increase the number of new treatments and drugs on the market by making it easier for them to meet evidence standards.
Decreasing expenditure on ineffective treatments could help to address the issue of rising healthcare costs. However, it takes about ten years for doctors to stop using medications that were found to be ineffective. Even when the medical community is generally aware of the problem, doctors may still use conventional treatments. For instance, doctors use stents despite their inefficiency because they want to avoid patient deaths, relieve the patient’s anxiety, and protect themselves in court.
Additionally, some doctors do not believe in scholarly evidence. Another example of ineffective treatments commonly used in treatment and disease prevention is beta-blockers. Atenolol slows the heart rate and reduces blood pressure, but is ineffective in preventing heart attacks and stroke. Doctors continue to prescribe it because it is a conventional treatment, and they lack knowledge about its ineffectiveness.
It is also essential to consider the pressure from patients, as it has an influence on doctors’ decisions to use particular treatments. It is true that many patients form strong beliefs regarding the type of treatment they need before they go to see a doctor. For example, some patients seek meniscal surgery because they found information about its benefits online and believe that it will alleviate their chronic knee pain. However, this surgery should only be performed if there is sharp, intermittent pain and motion reduction. What many patients do not realize is that anecdotal evidence is often misleading, and even the most effective treatments may not help all patients and may cause harm.
In medical settings, medications and procedures are evaluated using the number needed to treat and the number needed to harm measures. These provide a more accurate representation of the potential benefits and risks of treatment. The NNT refers to the number of patients who need to undergo treatment before it can prevent one additional adverse outcome. The NNH describes the number of patients who need to be treated with a specific medication or device before an additional patient is harmed.
Conclusion
On the whole, unnecessary spending is a persistent problem in the United States that involves both patients and doctors. Doctors often prescribe ineffective or unnecessary treatments because they lack awareness about their ineffectiveness or simply do not believe the evidence. Patients may also pressure doctors in performing procedures that are clinically ineffective. It is a common misconception that expensive, novel treatments are responsible for people’s improved health and longevity. As shown in the article, the increased life expectancy is mainly due to improved living conditions, hygiene, and vaccinations. Thus, treatments should only be used when they will benefit patients, and doctors should follow evidence-based protocols strictly in their practice.