Another Voice: Evidence-based medicine is critical to improving patient safety .

Alternative medicine



By Dr. Anthony J. Billittier IV

As a longtime member of the medical profession serving in a variety of capacities, I take great pride in the incredible breakthroughs being made seemingly every day to help combat and cure a wide variety of ailments.

Rapid advancements in scientific research and discovery greatly enhance our ability to treat some of the most common conditions along with many rare, challenging diseases.

Despite these advances, it was disheartening to read the Aug. 27 front-page article (“Untested treatments persist in medicine”) in The Buffalo News regarding two studies that found there is a near epidemic of unnecessary and unhelpful treatments being prescribed to patients in our nation’s health care system.

According to research published in the British Medical Journal along with a study conducted by physicians at the Oregon Health & Science University School of Medicine, up to 50 percent of treatments are of unknown effectiveness, and some are actually downright harmful.

As a profession, we have to stop thinking “traditional” vs. “alternative” medicine and commit to the explicit use of the best available medical evidence in making clinical decisions – providing patients with the right care, at the right level, at the right time, and in the right setting.

In partnership with primary care physicians and specialists, Independent Health continues to take steps to advance evidence-based treatments and protocols that result in less variation in care and higher quality results. As providers assume greater cost accountability, it is more important than ever to define and execute evidence-based standards of care.

In addition to my new position with Independent Health, on the weekends I continue to care for patients while teaching medical students and resident physicians in the emergency department at ECMC. I continuously impress upon these doctors in training if a certain test doesn’t change what you do or how you treat a patient, then don’t do it.

I also encourage patients to engage in conversations with their primary care and other health care providers, especially to ask questions about what tests, treatments and procedures are right for them – specifically, is this treatment supported by evidence, non-duplicative of other tests or procedures already received, relatively free from harm, and truly necessary?

Quite simply, more care is not better care. Over time, the movement away from the volume-based, fee-for-service model of provider reimbursement to value-based care that rewards providers for advancing safe, appropriate, and effective care will transform and improve health care delivery, reducing the number of unproven and unneeded treatments.

Billittier, Erie County’s former health commissioner, is executive vice president and chief medical officer of Independent Health.