News-Record.com

Back in August, I wrote about how a lot of drugs and procedures either aren't effective or address symptoms without treating the underlying cause. Such waste constitutes roughly a third of the more than $2.1 trillion we spend annually on health care, and it's almost ten times the highest estimate of what we could save with a national conversion to electronic health records.

The waste isn't just money, either. It's lives. The Institute of Medicine estimates that the number of annual U.S. deaths from preventable medical errors alone is between 44,000 and 98,000.

The biggest reason why the waste is so enormous is, of course, how common such wasteful drugs and procedures are. And how common is that? Via The Health Care Blog comes an article in Miller-McCune magazine that says your odds of getting the best evidence-based health care are roughly 55 percent -- barely better than a coin toss.

The figure differs according to the medical problem, the article says: Breast-cancer patients are likely to get the best evidence-based care about 76 percent of the time, but hip-fracture patients get it only about 23 percent of the time.

More disturbingly, patients receive a type of care they actually shouldn't receive about 20 percent of the time for chronic conditions (diabetes, say) and 30 percent of the time for acute ones (such as heart attack or stroke), a trend likely contributing to the numbers noted by the Institute of Medicine. And socioeconomic factors don't appear to make any difference, so even the wealthy at the best medical centers aren't immune, so to speak.

The article examines how doctors practice medicine as the basis for why the best evidence-based practices aren't followed. And it puts some blame on patients, who may insist on a type of care they don't actually need -- an insistence to which some doctors succumb rather than risk a malpractice suit.

Changing this approach will be an enormous project, but the payoff in lives and dollars makes such change essential.