Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-19T03:56:01.325Z Has data issue: false hasContentIssue false

Promoting Consumers' Demand for Evidence-Based Medicine

Published online by Cambridge University Press:  10 March 2009

Gianfranco Domenighetti
Affiliation:
Sezione Sanitaria
Roberto Grilli
Affiliation:
Istituto di Ricerche Farmacologiche Mario Negri
Alessandro Liberati
Affiliation:
Istituto di Ricerche Farmacologiche Mario Negri

Abstract

The widespread implementation of rationing and priority-setting policies in health care opposes the stochastic practice of medicine induced by professional uncertainty and professional vested interests in market-oriented clinical environments. It also clashes with consumers' overly optimistic and “mythical” view of the effectiveness of medicine, which is bound to support a potentially unlimited provision of health services. Thus, for consumers and society at large, it is necessary to create conditions favorable for a more conscious demand of evidence-based health care. In pursuit of this goal, we suggest the adoption of a community-oriented strategy based upon delivery of information to the public in order a) to generate greater awareness (“healthy skepticism”) among consumers, through disclosure of data on the true effectiveness of health care interventions and on the existing variation in their utilization, and b) to provide tools to empower consumers in dealing better with both the uncertainty in their own individual patient-physician relationships and with the health policy issues to be faced in the future. Such a community-oriented strategy could also reinforce and support, through the generation of a “bottom-up” pressure from consumers toward physicians, a wider adoption of evidence-based interventions by health care professionals. This paper, using data from surveys on public opinions and attitudes toward the practice of medicine, focuses on how consumer demand for more evidence-based medical practice can be promoted.

Type
Special Section: The Consumer And Technology
Copyright
Copyright © Cambridge University Press 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Bero, L., & Rennie, D.The Cochrane Collaboration. Preparing, maintaining, and disseminating systematic reviews of the effects of health care. Journal of the American Medical Association, 1995, 274, 1935–38.Google Scholar
2.Domenighetti, G.From ethics of ignorance to consumers' empowerment (editorial). Sozial-und Präventivmedizin, 1994, 39, 123–25.Google Scholar
3.Domenighetti, G., Bisig, B., Zaccheo, A., et al. Consommation chirurgicale en Suisse et comparaison avec la France. Lausanne: Réalités Sociales, 1996.Google Scholar
4.Domenighetti, G., Gutzwiller, F., Martinoli, S., & Casabianca, A.Revisiting the physician patient as an informed consumer of surgical services. International Journal of Technology Assessment in Health Care, 1993, 9, 505–13.CrossRefGoogle ScholarPubMed
5.Domenighetti, G., Luraschi, P., Casabianca, A., et al. Effect of information campaign by the mass media on hysterectomy rates. Lancet, 1988, ii, 1470–73.CrossRefGoogle Scholar
6.Granados, A., Jonsson, E., Banta, H. D., et al. EUR-ASSESS project subgroup report on dissemination and impact. International Journal of Technology Assessment in Health Care, 1997, 13, 220–86.Google Scholar
7.Grilli, R., Freemantle, N., Minozzi, S., et al. The impact of mass media campaigns on health services utilisation and health care outcomes. A systematic review of the literature Final report to the U.K. National Health Service Research and Development Program. Milano: 04 1997.Google Scholar
8.lerodiakonou, K., & Vandenbroucke, J. P.Medicine as a stochastic art. Lancet, 1993, 341, 542–43.CrossRefGoogle Scholar
9.Levinson, W., Stiles, W. B., Invi, T. S., & Engle, R.Physician frustration in communicating with patients. Medical Care, 1994, 4, 285–95.Google Scholar
10.Mooney, G.Key issues in health economics. New York: Harvester Wheatsheaf, 1994.Google Scholar
11.Reiser, S. J.The era of the patient: Using the experience of illness in shaping the mission of health care. Journal of the American Medical Association, 1993, 269, 1012–17.CrossRefGoogle ScholarPubMed
12.Sackett, D. L., & Haynes, R. B.On the need for evidence-based medicine (editorial). Evidence-Based Medicine, 1995, 1, 56.Google Scholar
13.Sackett, D. L., Rosenberg, W. M., Gray, M. J., et al. Evidence-based medicine: What it is and what it isn't. British Medical Journal 1996, 312, 7172.CrossRefGoogle ScholarPubMed
14.Smith, R.The ethics of ignorance. Journal of Medical Ethics, 1992, 18, 117–18, 134.Google Scholar
15.Smith, R.Where is the wisdom? The poverty of medical evidence. British Medical Journal, 1991, 303, 798–99.CrossRefGoogle Scholar