More on the Science of Health Care

More on the Science of Health Care – Tex Heart Inst J. – Jun 2017

Mark Scheid skillfully reviews a provocative book that challenges the theory and practice of population medicine (PM).

The book’s author—Michel Accad, is a practicing cardiologist.

Accad attributes the healthcare community’s widespread embrace of PM to 3 factors:

• the economics,
• the science, and
• the ethics of health care.

This editorial focuses on the science of health care, highlighting the intimate ties between PM and evidence-based medicine (EBM). 

‘Population Health’ Versus ‘Person-Centered’ Healthcare

Population health: At odds with person-centered healthcare | Accad – 2017

This is an open-access PDF article making the case that the trend towards population health is leading to more guidelines and standardization and less individual care.

This is exactly what I’ve been seeing as a huge flaw in pain management these days: it’s not tailored to the individual but determined by various government agencies now interfering with our treatment.

To conclude, the population health movement is an ambitious attempt to determine and improve the health of large groups of individuals “top down,” by identifying and modifying socioeconomic contexts and global health outcomes. 

The framework of population health, however, necessarily diminishes or subverts the traditional concept of health, rooted in the integrity of the person.  

Stanford finds personalized approach to opioids better

Opioids: Stanford researchers find personalized approach a better way to prescribe painkillers – By Denise Dador – Dec 2019

This article demonstrates the importance of personalization for quality healthcare and shows that standards are inappropriate for medication choice and dosing.

Why do some people get addicted to opioid painkillers and others don’t?

Stanford School of Medicine researchers have developed an innovative program called the Humanwide Project. Through wearable technology, genetics, and other tools, it aims to personalize care and take the mystery out of how we work.

Debbie Spaizman was nearly sidelined by a health concern. Surgery was needed, but she hesitated due to how she reacted to pain medication.  

Pain Needs Patient-Centered and Individualized Care

The HHS Pain Management Best Practice Inter-Agency Task Force Report Calls for Patient-Centered and Individualized Care – Jianguo Cheng, MD, PhD, FIPP, Molly Rutherford, MD, MPH, FASAM, Vanila M Singh, MD, MACM – January 2020

At least these folks see the reality: for pain, both acute and chronic, standard treatment with standard doses of standard medications is simply not medically appropriate. Pain treatment is not suitable for standardization.

Some healthcare services must be personalized to be effective, even when they become much more complicated and difficult (meaning, expensive).

The same people insisting on standard dose limits for opioids wouldn’t think of suggesting standard dose limits for blood thinners or insulin or cancer treatments.

The Pain Management Best Practices Inter-Agency Task Force (Task Force) was convened by the US Department of Health and Human Services (HHS), in conjunction with the Department of Defense, the Department of Veterans Affairs, and the Office of National Drug Control Policy.