Evidence-based medicine: health care's next holy war

To review evidence-based medicine (EBM), how it emerged, how it works, and what drug utilization patterns across the United States would look like if we applied EBM methods to this population.

There is a collective presumption about the overuse of pharmaceuticals, unchallenged by any substantive data, that has become part of American folklore: high drug use by people in this country actually represents overuse. This presumption is completely unfounded. On the contrary, a recent analysis carried out by the RAND Corporation indicated that fewer than 70% of people in the United States with chronic illness receive adequate medical treatment.

The flow of almost all medical research strongly supports the conclusion that more medicine is better. EBM has ably pointed out that too many patients receive unneeded diagnostic and surgical procedures. It will also demonstrate that too few patients receive appropriate medical care.