The .Plan

I described this phenomenon in a talk I gave yesterday, but not nearly so eloquently…

[The sheer abundance of medical knowledge] crowds out an important — in fact, the only — skill that matters in treating a patient: how to critically appraise published clinical trials. Few doctors ever read them. In effect, medicine has become a priesthood of practitioners who never review or learn to interpret the Bible to minister to their flock; they instead rely on secondhand wisdom. Or, worse, on Google.

That is why, for example, the average internist can describe the branching patterns of the major coronary arteries but not the primary clinical trials assessing how much, if at all, various cholesterol-lowering agents cut heart-attack risks. Or, for that matter, whether the trials were soundly conducted… Filling the training vacuum, an unregulated, for-profit industry of information peddlers is emerging to interpret clinical trials and guide treatment.
–Darshak Sanghavi, “Training Daze”, Slate, March 12, 2008