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Saturday, October 7, 2017

Healthcare Journalism Needs to Change to Help Patients

Healthcare used to be "paternalistic," because doctors told patients what to do. There was no Internet and little information was available for patients. Paternalism resulted in bad things, such as the epidemic of unnecessary hysterectomies. Today, healthcare is "paternalistic/maternalistic," because 3rd parties are telling doctors what to do, and then doctors tell patients what to do. Why can't doctors and patients figure out treatments together? Why can't we have shared decision-making?

Why are things so rotten? Because there is so much disorganized information. Physicians are not practicing evidence-based medicine, they are practicing Eminence-based medicine or Authority-based medicine. This is resulting in bad things happening to patients: over-treatment, under-treatment, mistreatment and even harmful treatment. Journalists, and patients, are going to have fix this from the bottom up. Healthcare journalists of the future are going to have to give patients the information that is relevant to them, or publishers will lose their audiences to publishers that do provide relevant information.

What will you do if your mother is diagnosed with ovarian cancer? What will you do if your father gets prostate cancer? What will you do if your child gets Hepatitis C? What will you do if you suffer from insomnia? What you will need is a list of treatments and Treatment Scores for your specific diagnosis.

If you want to learn about Treatment Scores, and help patients, please contact me at: Dr.Hennenfent@gmail.com
But first, please read the rest of this essay:

The Treatment Score = the net treatment benefit for the patient. There are often 5 or 10 treatments for a disease. Breast cancer has 30 treatments. For insomnia, there are 130!

Remember: "There are three kinds of lies: lies, damned lies, and statistics."(1)

You might assume your physician knows all the statistics. You might assume your physician practices evidence-based medicine. If you assume these things, you are mostly wrong. A 2015 study, a randomized survey across eight countries, showed that the majority of physicians do not understand treatment effects.(2) Thus we have the blind (physicians) leading the blind (patients).

You must be your own best healthcare advocate. You cannot leave understanding medical statistics up to your doctor. They don’t have the time or the tools. It's much better if you learn the numbers yourself and take them to your physician for discussion. Only then can you have genuine shared-decision making and informed consent.

When I was Chief Resident in Emergency Medicine, at the end of Journal Club, I would ask the attending physicians, “What would you do?” They would often say, “Well the Jones study said that” but “the Smith study said that.” In other words, they would equivocate, because medical information is in a large disorganized cloud of over 25 million studies. There is not enough organization; there is not enough clarity.

Once, when I was at Morning Rounds in surgery. Two attending surgeons started screaming at each other over how to treat a patient. Surgeon 1 screamed, "The Anderson study said X percent!" Surgeon 2 screamed, "The Jones study said Y percent!" I remember thinking if only we could only visualize their logic we would know which physician was more correct.

Do you want to help patients? Patients, and patient advocates, want these four deadly problems solved:
  1. There is an 88% health illiteracy rate among patients (Health.gov)
  2. 60 to 80% of physicians don't understand treatment effects (CMAJ)
  3. The Patient-Centered Outcomes Research (PCORI) team says, “Every day, patients and their caregivers are faced with crucial health care decisions while lacking key information that they need.”
  4. PCORI also says that we need to translate “…existing scientific research into accessible and usable formats…”
We have created the solution for all four problems; we produce Treatment Scores. The Treatment Score = “the net treatment benefit for the patient.” Treatment Scores put patients first by summarizing medical studies from the patient's point of view. Patients have always needed Treatment Scores. Could the stakes be any higher? Patients' lives are at stake and their health is at risk. Your health is at risk.

How to explain Treatment Scores? Most of us figure out our “gross income” and “net income” every year. Why can't we summarize the “gross treatment benefit” and the “net treatment benefit” for patients from the medical literature? It is simple with Treatment Scores' technology.

Did you see the movie “Moneyball” about Sabermetrics starring Brad Pitt? Treatment Scores are “Sabermetrics for medicine.” Sabermetrics have revolutionized sports. Treatment Scores will revolutionize healthcare for the same reason, because like Sabermetrics, Treatment Scores reduce disorganized data down to one number.

Patients are suffering because they cannot understand complex medical studies. Patients need understandable treatment transparency. If you want to learn about Treatment Scores and help patients, please contact me at:
Dr.Hennenfent@gmail.com

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SOURCES
1. Mark Twain and Benjamin Disraeli are both credited with the quote: There are three kinds of lies: lies, damned lies, and statistics.

(2) Bradley C. Johnston, PhD, et al. "Do clinicians understand the size of treatment effects? A randomized survey across eight countries."
http://www.cmaj.ca/content/early/2015/10/26/cmaj.150430

America's Health Literacy: Why We Need Accessible Health Information
https://health.gov/communication/literacy/issuebrief/

Do clinicians understand the size of treatment effects? A randomized survey across 8 countries
http://www.cmaj.ca/content/early/2015/10/26/cmaj.150430

Patient-Centered Outcomes Research Institute
http://www.pcori.org/assets/FINAL-PFA-Communication-and-Dissemination-v3.pdf

DISCLAIMERS
Treatments Scores, Inc. and associated individuals do not claim to diagnose, cure, treat, or prevent any disease. Treatment Scores are an educational system to help you figure out the science of medicine behind treatments, which should be the starting point for shared decision-making for all diagnoses. The information on this website should never be used as a substitute for the advice of a qualified, licensed physician or healthcare professional. We are not advocating any treatment, physician, medication, or any other entity. We are informational or educational only. We do not form physician-patient or doctor-patient relationships. Contact your physician for medical treatment. Call 911 if you may have an emergency or go to the Emergency Department. We are not responsible for any delays in care from information obtained from our site, nor for any consequential damages of any nature whatsoever, either directly or indirectly related to the use of this site, or from assumptions made. We cannot predict the future, we are only trying to do a better job of quantifying and reviewing what has happened in the past. We claim ZERO accuracy. We claim zero accuracy, because in medicine every patient is different, every statistic is a flawed statistic in some way, there are always estimations, and there is always bad or missing data. Averages may be used and no patient is average, every patient is unique. We make no promises or warranties whatsoever. SEE YOUR OWN PHYSICIAN FOR TREATMENT.

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Copyright © 2017 Bradley R. Hennenfent, M.D. All rights reserved.

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