Why don't all doctors treat patients the same way? Discussion at U of Michigan

[Guest guest]

Hi,

someone from this list visits this event on Friday? It will be

interesting to hear some of the main points.

Peace

Torsten

Why don't all doctors treat patients the same way?

Nov. 1 event will examine differences in physician practice

ANN ARBOR, MI -- No one wants a cookie-cutter doctor, who treats every

patient with the same condition exactly alike, without any regard for

individual differences. But then again, no one wants a doctor who

doesn't

give proven treatments to everyone who can benefit from them.

Somewhere between these two extremes, there's a lot of room for

differences in how individual physicians practice medicine on

individual

patients. But studies have shown huge differences in the medical care

received by Americans living in different regions, belonging to

different

ethnic groups, or having different ages or incomes.

Whether on an individual or national level, these differences in

physician practice are important to the nation's health. On Friday,

Nov.

1, experts from the University of Michigan, Dartmouth Medical School

and

Blue Cross Blue Shield of Michigan will address the issue in a lecture

and discussion session titled " Physician Practice Difference: What is

it,

Why is it, and What Next? " .

The event, from noon to 1:30 p.m., is free and open to the public.

Co-sponsored by the U-M FORUM on Health Policy and the Department of

Internal Medicine in the U-M Medical School, it will begin with a

talk by

Wennberg, M.D., M.P.H., a Dartmouth professor who has performed

extensive studies in the area.

Following the talk, a panel of U-M and BCBSM experts will lead a

discussion of the issues involved, and take questions from the

audience.

" Every day, doctors around the country make different decisions about

the

care of patients with similar conditions -- which drugs to prescribe,

which tests to order, and which preventive steps to recommend, " says

FORUM director and event moderator Marilynn Rosenthal, Ph.D. " They

base

those decisions on everything from the latest research results to

their

sense of the patient's personality. But we need to look at how those

differences in decisions affect the quality of American health care. "

Among the factors that create differences in the ways physicians

practice, Rosenthal says, are medical uncertainty, patient

differences,

incentives for physicians to practice in certain ways, and style and

experience differences between physicians.

For example, some physicians may choose not to adopt new techniques

immediately after their introduction, because they don't see enough

research-based evidence to satisfy them that the new approach is

better

than what they've been using.

Meanwhile, national medical organizations and government agencies are

putting more emphasis on collecting the best-available evidence about

treating certain diseases, and compiling guidelines and standards they

hope doctors will follow.

Wennberg, the event's featured speaker, has co-led studies showing

major

differences in the rates of certain medical and surgical treatments

between different geographical regions. He is the principle

investigator

and editor of the Dartmouth Atlas of Health Care, which examines

patterns

of medical practice across the United States.

Recently, Wennberg and his colleagues have pursued research into the

role

of the patient as an active participant in treatment, and the number

of

physicians needed in the American health care system. He is director

of

Dartmouth's Center for Evaluative Clinical Sciences, and holds the

Peggy

Y. Thomson Chair for Evaluative Clinical Sciences.

The panelists for the Nov. 1 event will be Gilbert S. Omenn, M.D.,

Ph.D.,

former U-M executive vice president for medical affairs and a noted

public health and health services researcher; Mark Fendrick, M.D.,

M.P.H., co-director of the U-M's Consortium for Health Outcomes,

Innovation and Cost Effectiveness Studies and an associate professor

in

both the U-M Medical School and School of Public Health; and nne

Udow, vice president of BCBSM. Wennberg has consulted for BCBSM and

prepared a Dartmouth Atlas of Healthcare in Michigan for BCBSM in

2000.

The event will be introduced by Rosenthal and by Marc Lippman, M.D.,

chair of internal medicine at the U-M Medical School.