Evidence-based practice = lower cost, fewer health disparities

Atul Gawande, MD

Atul Gawande, MD

I’m often at odds with Atul Gawande’s views on health care reform in the United States. I’m a staunch supporter of a single-payer, government-run, national health care plan; he supports a market-based system. However, of late, Dr. Gawande has been speaking out in support of the accountable care organization concept pushed by the Dartmouth Institute for Health Policy and Clinical Practice. To the extent that such organizations strive to deliver low-cost, high-quality health care to the communities they serve, Gawande, the Dartmouth Institute, and I are all on the same page. (I go further and say that we need such organization on a national scale. All health care providers would be organized into such teams in a national health care plan, rather than voluntarily doing it as smaller, market-based units.)

In his recent New Yorker magazine article, Dr. Gawande tells a vivid and moving story about the reasons for the high cost of medical care by focusing on McAllen, Texas, which is a border town with one of the most expensive health care markets in United States. It’s a must-read article.

I also think you should read Maggie Mahar’s June 12th post in her blog, Health Beat. In this posting, she prints excerpts from Dr. Gawande’s address to the graduating class at the University of Chicago’s Pritzker School of Medicine. Evidence-based practice, which we emphasize in the training of our family medicine residents here at UVa, results in high-quality, low-cost care. I also believe it leads to more equal care because it mitigates the influence of implicit racial bias and stereotyping.

Thursday, June 18th, 2009 at 15:34