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[Dysphagia] Medicare holidays
"Connors, William A." <connorswa@ph.upmc.edu> wrote:
The third relates to patient care: quality of patient care/gold standards for patient care/evidence-based medical practice/ethical factors in patient care.
*** Your point is well taken - and the issues range far beyond local or even national boundaries. Quality of patient care requires, first and foremost, well educated and skilled clinicians with the awareness that any profession requires ongoing self education as well as self examination as to skills and knowledge.
Gold standards for patient care are always elusive and will probably never be universally agreed upon. For example, it seems to be widely accepted that VFSS is the "gold standard" for swallowing assessment when, increasingly, it is evident that it is not.
Evidence based? In swallowing disorders there is very little that deserves the label except at the lowest level of confidence. See this new article:
Evidence Based? Caveat Emptor!
Earl P. Steinberg; Bryan R. Luce
Health Aff. 2005; 24 (1): 80-92.
There is much variation in the validity of health care-related recommendations and practices that claim to be "evidence based."
Abstract and IntroductionAbstract
Medical practices, clinical practice guidelines, clinical performance measures and measurements, and a variety of health care-related administrative decisions, such as insurance coverage decisions, are claiming to be "evidence based" with increasing frequency. In this paper we examine the "evidence based" label; discuss how evidence ought to have been assembled, evaluated, and synthesized; and when evidence is sufficient for the "evidence-based" moniker to rightfully apply. We also highlight several considerations other than the strength of evidence that are relevant to several common types of health care-related administrative decisions and that influence the extent to which the resulting decisions are truly evidence based.
And ethical issues require an entire level of study all by themselves.
Irene.
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
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