Der ELSE Ansatz in der ärztlichen Beratung

The author of a recent NY Times opinion article, Gilbert Welch, argues that we are not putting enough effort into challenging standard practices in medicine, but instead focus too much on accommodating and streamlining those practices already established, and on coming up with ever new diagnostic and screening tools, treatments and procedures to spend health care money on. This is despite prominent examples like hormonal replacement therapy after menopause or PSA screening, that should remind us to keep a certain amount of skepticism. While arguments constantly circle around who should pay for all the blessings of modern medicine, it is often not so clear which existing or newly approved treatments are actually worth it (another example is the revoked fast track approval of bevacizumab for breast cancer). The responsibility however is still mostly on the physician, including that of dealing with insurers and insecure patients. With clinical to-do lists and guidelines growing longer, one important distinction to make is that between efficiency (performing a given task in the most economical manner) and effectiveness (capability of producing a desired result), nicely depicted by Tim Ferriss in “The 4-Hour Workweek”: Doing something unimportant well [meaning: efficient] does not make it important. What […]