Many physicians have resisted evidence-based medicine guidelines over the years—sometimes for good reason. Some still refer to evidence-based medicine by the epithet "cookbook medicine," saying that because each patient is different, there's no way to prospectively determine what particular interventions will work best for a particular patient with a particular malady or group of maladies.
Hospital administration, in the past, has not been much help. Halfhearted attempts to force physicians to adopt evidence-based medicine practices have been hampered by the fact that reimbursement has rarely been at stake.
Furthermore, attempts to push through such changes have often come from administrators. Doctors don't tell them how to do their jobs (don't they?) so an administrator shouldn't tell him how to do his.
So it wasn't necessarily the message but the messenger. I'm finding that physician resistance to implementing such guidelines is fading in the face of
- Better and more thorough clinical research
- Electronic medical records that incorporate that research in the form of reminders and accessible research
- A younger cadre of physicians who are no longer resistant to computer or other technological assistance in diagnosis
- A reordering of the responsibilities and accountabilities of the chief medical officer
Philip Betbeze is the senior leadership editor at HealthLeaders.