Medical guidelines overly aggressive, expensive in US

Dr. Sunita Sah practiced general medicine for several years in the United Kingdom’s National Health Service. When she came to the United States, she noticed something strange.

The U.K. guidelines for tests such as mammograms and colon cancer screenings drastically differed from those in the U.S. — even though they were based on the same medical evidence.

“Having colonoscopy at the age of 50 — that struck me as rather odd when I moved to the U.S., because you don’t really hear about people having colonoscopies as a screening procedure in the U.K.,” said Sah. “It’s much less invasive to test for blood in the stool. It’s also less costly and doesn’t have the risks of undertaking a colonoscopy.”

Now an assistant professor of management and organizations at Cornell, Sah and Ismail Jatoi of the University of Texas Health, San Antonio, say the treatment guidelines recommended by medical specialist organizations are more likely to call for greater use of health care services and exacerbate overdiagnosis, overtreatment and spiraling health care costs. Their commentary, “Clinical Practice Guidelines and the Overuse of Health Care Services: Need for Reform,” appeared March 18 in the Canadian Medical Association Journal.

The implications are significant, she said, because guidelines are supposed to provide standard evidence-based treatment practices for all doctors….

Here’s a radical and “aggressive” approach to medicine: get a clue about the importance of nutrition.   American doctors are practically illiterate in this area.

Would you take your car to a garage that didn’t know the difference between sugar and gasoline?

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