The Battle over Evidence-Based Medicine
“[T]here is tremendous pressure from powerful economic actors to maintain the health care status quo. Eliminating a dollar of waste in the health care system usually means reducing someone’s income.” —from Unhealthy Politics
In 2002 Eric Patashnik, PhD, MPP, a professor of public policy and political science at Brown, came across a puzzling study in the New England Journal of Medicine, which found that a widely used surgical procedure for osteoarthritis of the knee worked no better than a sham procedure.
Assuming that common medical treatments must rest on evidence of their effectiveness, Patashnik and colleagues Alan S. Gerber of Yale and Conor M. Dowling of the University of Mississippi began to investigate why the procedure had become popular and how doctors responded to the landmark study. The political scientists found that the knee surgery case is illustrative of broader problems in the US health care system and that treatments contradicted by evidence can remain the standard of care for decades.
In their new book, Patashnik and his co-authors look at how partisanship, political polarization, and medical authority stymie efforts to promote better, more efficient health care for Americans. They draw on public opinion surveys, physician surveys, case studies, and political science models to explain how political incentives, physicians, and partisanship undermine evidence-based medicine.
Got a new book? Have your publisher send us a copy at Box G-P, Providence, RI 02912. Listen to an interview with Patashnik at soundcloud.com/watsoninstitute/medicine-in-america.