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Evidenced based medicine; Evidence for whom

By GregStarr ·
As a physician, I personally resent the term "evidenced based medicine." Let me give you an example, back in the day of DRG's (Diagnosis Related allocatable hospital stays.) The doctor would do his work on the patient and fill the chart as customary. Once a doctor became savvy to the DRG document requirements, he would make sure that his chart was acceptable for the DRG review done by a nurse who attempted to manage the patient strictly through the chart. This DRG nurse frequently look at the patient nor did they consider more than one problem designated by the DRG. Futher the time allocated for a particular disease was designated the median time that this particular disease was designated as the median time that a patient with such a disease. There was no room for outliers and physicians were labeled as "delinquent" if they didn't comply.

Obviously the language is all wrong and it fires a resentment and disregard for those using the terms. Obviously a nurse with a white coat and a clipboard has no buisness telling a doctor when to discharge the patient and calling the doctor and his behavior derogatory epithets has no place on the medical floor.

With greater transparency in the chart system these power plays can be avoided. Doctor's can be informed privately of their lengths of stay realizing that their may be outliers and the information would have considerably less friction involver. If there is a consistent over utilization pattern, the physician can be taken aside and the specific problems can be discussed. With an attempt to create transparency there is no place for adversarial language and it should be eliminated now.

Craig Linq

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Wonderful

by havenja07 In reply to Evidenced based medicine; ...

This is a wonderful opinion. The things mentioned are unanimous and needs to be appreciated by everyone. I appreciate the concern which is been rose. The things need to be sorted out because it is about the individual but it can be with everyone.
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