Healthcare Matters

Your “second opinion” has found the web. A new company, called GuidelineMedicus, has just launched a searchable database of evidence-based medical guidelines (EBMGs). “Is my doctor recommending the best possible treatment for me?” While that’s the kind of question GuidelineMedicus endeavors to help answer for John Q. Patient, what the company actually wants to motivate is a more productive dialogue between doctors and patients –and that’s a value prop that is right on time.

Here’s the story:

Dr. Harry Eisenbach has been practicing medicine in California since 1978 and spent the latter part of his career working in the field of medical peer-review, assessing the medical necessity of treatments and surgeries, at the request of insurance companies. It was during this period when Eisenbach discovered evidence-based medical guidelines (EBMGs), which are considered the “gold standard” for identifying the criteria for the medical necessity of any medical treatment or surgery.

Eisenbach explains:

“A member of my immediate family sustained an injury to his neck. He was advised to undergo cervical fusion surgery by an esteemed neurosurgeon. Trusting the neurosurgeon’s advice, and without first looking-up the applicable EBMGs, I advised my family member to undergo the surgery. The procedure was performed uneventfully. However, several weeks later I received an inquiry from an insurance company questioning the same type of surgery in an unrelated case. This was when I had initially looked-up the EBMGs for cervical fusions, when I discovered that a prerequisite for such surgery was that a patient must first fail at least three months of conservative care. Given that my family member underwent the cervical fusion surgery only one week after his injury, with no conservative care whatsoever, it became obvious that his surgery was clearly premature, if not entirely unnecessary. “It was then that I realized that average medical consumers need to use EBMGs and they should discuss these guidelines with their personal physicians. This would help consumers avoid any unnecessary treatments or surgeries. Thus, the concept for GuidelineMedicus.com was born.”

Eisenbach launched GuidelineMedicus.com as a resource for consumers who are struggling with difficult personal medical decisions. Finding the applicable EBMGs for consumers provides them with a reliable point of reference for determining if any treatment or surgery is appropriate or not. GuidelineMedicus.com links visitors directly to PubMed, the search engine for the National Institutes of Health (NIH), where they can search for any EBMGs among over 21 million citations for biomedical literature, entirely free of charge. GuidelineMedicus.com also offers individualized searches by request for any EBMGs, for which there is a nominal fee.

“It’s vital that patients have the tools to make informed decisions about their own treatment,” continued Eisenbach. “Following the observations I made during my 7-year medical peer-review career, it’s imperative that consumers use EBMGs in collaboration with their own physicians to arrive at the best possible personal medical decisions.” GuidelineMedicus.com searches for evidence-based medical guidelines on behalf of the average medical consumer. These guidelines reflect the patient selection criteria for any medical or surgical treatment in a simple and understandable format.

When reading up on GuidelineMedicus, I couldn’t help but notice that the founding doctor’s seminal idea resulted from a “non compliant” cervical fusion procedure that he knew about –a surgery that coincidentally happens to be on the short list of most over-performed procedures.

Our politicians will remain confused and conflicted, debating this and other related topics (e.g. Comparative Effectiveness Research (CER), Evidence Based Medicine (EBM), etc.) in a rationing context. That’s to be expected. But frankly, regardless of how you cut reform, demystifying “the process” and empowering customers with better information is not only a natural evolution for any industry, but it unquestionably equates to better patient outcomes and significant cost reductions in healthcare.

—Tom Finn