Where’s the Beef?

We put our doctors’ feet to the fire by demanding evidence (the “beef” or proof) before making medical recommendations. Experience has proven that decisions based on hard data always work out better than decisions based solely on logic.

However, health care outcomes are as dependent on managers, legislators, and particularly regulators as they are on doctors and nurses. Do we hold managers and regulators to the same standard – for evidence – as doctors? Not even close!

The latest 800-pound gorilla (regulation) imposed on the medical world is HIPAA:  Health Insurance Portability and Accountability Act). It was originally intended to protect workers’ health insurance when they change jobs, but that is not what the final bill did at all. HIPAA now requires all sorts of protections for medical information confidentiality.

Where was the evidence that there was a problem with improper distribution of sensitive information? There was none. Where was the evidence that HIPAA would fix the alleged problem? Nada. HIPAA is the classic fix that fails. It did not solve the problem for which it was intended: people still lose their health insurance along with their job. HIPAA did succeed in one thing: it makes sharing medical information difficult-to-impossible.

This happened because regulators are not required to make evidence-based decisions. When a doctor makes a decision without evidence, it is called negligence. Shouldn’t it we call it the same thing when done by regulators?

Regulators should commit to prove in advance that what they decide will achieve what they say it will. Then they will know the answer to: “Where’s the beef?”

System MD

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21 comments ↓

#1 We’re Drowning And Your Coming With Us — Medical Malprocess on 10.25.09 at 4:06 am

[...] and frustration; impedes communication; increases errors; encourages lawsuits; with absolutely no evidence of a problem in the first place and no proof that it works [...]

#2 The Fix That Fails, And Worse — Medical Malprocess on 10.25.09 at 4:13 am

[...] are four reasons for fixes that fail or make things worse. 1.    No evidence before action 2.    Act on (treat) effects not causes 3.    Measure wrong outcomes or not [...]

#3 Are You A Systems Stinker? — Medical Malprocess on 10.26.09 at 3:20 am

[...] lines. They understand that their actions can come back and bite them in the rear. They develop evidence before they act. Their systems have feedback built in. They consider unintended consequences and [...]

#4 Accept No Substitutes – A Pre-election Interlude — Medical Malprocess on 10.29.09 at 7:52 pm

[...] loudly proclaims that a specific solution will work, calmly ask for the evidence, not their logic, PROVING that it will [...]

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