The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Opinion: Politics Should Not Trump Science in Medicine

Opinion: Politics Should Not Trump Science in Medicine

April 15, 2016 • By John A. Goldman, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF
Medicine has been taken over by administration, which stifles scientific innovation.

Medicine has been taken over by administration, which stifles scientific innovation.
science photo/shutterstock.com

I tell my patients there are three types of science: 1) investigative science, which sometimes gets it right; 2) science in the courtroom, which is junk science; and 3) science in Washington, D.C., which is political science.

You Might Also Like
  • RheumPAC: It’s Not About Politics
  • Will a Hybrid Concierge Medicine Model Work for Rheumatologists?
  • Opinion: Why Rheumatologists Should Adhere to Standard of Care
Explore This Issue
April 2016
Also By This Author
  • The Most Cost-Effective Diagnosis Is the Correct Diagnosis

Our decisions are based on art and science; our patients’ medications are brought to market based on science. And yet the way we are now extorted to treat and mandated to care for our patients is not based on any science. It is political science.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

We need to make medicine great again. What’s happening? Here are a few examples:

Prior Approval

We write an FDA-approved medication prescription for our patient for a specific medical condition, and then we are told by the patient’s insurance company that we cannot use that medication; we need to use another FDA-approved medication in the compendium, which does not have an FDA label indication for the medical condition we want to use it for. This medication is not what we want to use, but if we don’t, we cannot treat our patient. Then they turn the tables around when we want to use an FDA-approved medication supported by literature to work for a condition not listed on the approved label, and they decline it based on the package insert—right drug, wrong disease.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

In these examples, science does not trump politics or economics. This practice is executed by insurance companies and is called non-medical switching. It’s not based on medical science, but on insurance pseudo-science.

Electronic Medical Records

I think electronic medical records (EMRs) have great promise.1 I began using one program, QD, in 1998 for that reason. Slowly, it was integrated into my care, and we have used it full time since 2008. QD was developed by physicians, including rheumatologists, for physicians. It is still great and gives me the ability to personally change the program on the fly at any time to help the care of the patient. (Note: You can’t do that with the big guys, where program changes need to be implemented centrally and take a long time.) But the typical EMR picture is one of a physician typing on the computer with his back turned to the patient.

Thus, the computer is imposed and now takes precedence in the doctor–patient relationship. The AMA white paper on the inefficiencies of EMRs emphasizes that they are time consuming and prolong patient visits.2 Only an approved EMR allows one to qualify for Meaningful Use, but EMRs have not truly shown a benefit in patient care or reduction in cost of care. Hopefully, the assistance of the AMA and its presence on this issue will help us in this setting. Edward J. Schloss, MD, writes that healthcare documentation is performed for three reasons:3 1) Healthcare delivery (that’s the obvious one); 2) Regulatory compliance (checking all the boxes our government and payers think are important); and 3) Malpractice avoidance (no one wants to get sued).

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Pages: 1 2 3 | Single Page

Filed Under: Legislation & Advocacy, Practice Management Tagged With: Advocacy, AMA, American Medical Association, Electronic medical records, FDA, ICD-10, Medication, medicine, patient care, Politics, Practice Management, rheumatologist, rheumatology, scienceIssue: April 2016

You Might Also Like:
  • RheumPAC: It’s Not About Politics
  • Will a Hybrid Concierge Medicine Model Work for Rheumatologists?
  • Opinion: Why Rheumatologists Should Adhere to Standard of Care
  • Opinion: Role of Rheumatology Nurse Should Be Expanded

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.