Study: Medical care not always optimal

A new study in the June 26 edition of The New England Journal of Medicine found that Americans have only slightly better than even odds at receiving optimal medical care when they see their physician or are treated in a hospital, The Wall Street Journal reports. The report examined whether "best practices," the term given for optimal care as established by a panel of experts, were followed in a variety of settings and for several diseases and ailments. The study of medical records of about 20,000 adults in 12 U.S. cities showed that best practices were followed about two thirds of the time for ordering diagnostic tests, prescribing drugs, and monitoring long-term health. However, only about 20% of patients received optimal care in the areas of counseling and health education. Best practices were followed most of the time by health care providers in treating breast cancer, high blood pressure, depression, heart disease, and lower back pain but were adhered to less than half the time when addressing pneumonia, bladder infections, diabetes, and peptic ulcers. Alcohol dependence was the least likely condition for which health professionals adhered to best practices, with only about one in 10 patients with an alcohol problem receiving optimal care. "Everyone is at risk of failing to get care that they need to live a longer and healthier life," Elizabeth A. McGlynn, a researcher at consulting company Rand, which conducted the study, told the Journal. "It is time to stop having a debate whether we have a problem and start having a talk about how we can solve the problem." Some physicians were surprised by the study's findings. "If auto repair defect rates were the same as this, we wouldn't be alive today," Donald M. Berwick, a pediatrician who heads Boston's Institute for Healthcare Improvement, told the Journal. "This is something that the public ought to be very concerned about. We ought to set a national agenda for dramatic improvement of care."