#1 Trump shuts down federal office dictating guidelines for doctors by algernonpj 23.06.2018 21:32


Trump shuts down federal office dictating guidelines for doctors
Many physicians blamed program for 'culture of cookie-cutter care that's bereft of art and flexibility'

Published: 24 hours ago

When you’re sick and go to the doctor, your intent is to get expert medical advice – but you aren’t inclined to call the feds.

Recognizing that, the Trump administration has decided to shut down a service that dished out guidelines to doctors dictating which treatment is best for particular patients and when.

The Citizens’ Council for Health Freedom praised the move to close the Agency for Healthcare Research and Quality’s National Guidelines Clearinghouse.

“Effective July 16, the clearinghouse will no longer house the repository of ‘guidelines’ that are often used to direct physicians on the care of their patients,” the report said.

“The end of this federal repository of treatment protocols is not only a monetary savings for the country, but also keeps the government officials from using its power and influence to direct the practice of medicine,” said CCHF President Twila Brase.

“The decision to defund this clearinghouse takes away one element of control that can be imposed by electronic health records,” she explained. “Doctors are often tracked by their adherence to these and other standardized treatment protocols as a way to measure the so-called ‘quality’ of their practice and their treatment decisions – which is at the core of the controversial ‘evidence-based medicine’ philosophy.”

She said they experience “penalties for ‘going outside the lines’ despite making the best decisions for their patients.”

“Therefore, the end of this taxpayer-funded clearinghouse is good for patients and doctors.”

She has investigated the issue of medicine and privacy, and recently evaluated more than 125 studies and reports on electronic health records.

The life-sciences news website STAT reported even supporters of the program admitted the information is available elsewhere.

The report said the defunding is effective July 16.

“While the recommendations will still exist elsewhere after that date, anyone hoping to find out, say, how best to treat a teenager with asthma, or who should have a particular test, will have to work harder to locate the most current guidance. The NGC itself will disappear,” the report said.

“Killing these resources to save a few hundred thousand dollars per year is a penny-wise, pound-foolish decision, and your health and mine will be poorer for it,” said Kenny Lin, a family physician in Washington, D.C.

But the report noted that “similar repositories do exist.”

An agency statement said that while some may miss the NGC at first, “in today’s information-rich environment, they’ll have the ability to find guidelines in other places, such as with organizations that develop guidelines.”

“Likewise, information about guidelines’ trustworthiness will be available from peer-reviewed publications and other sources.”

Another doctor, Roy Poses of Brown University, described it as an “important resource.” But the report said “some doctors are not fond of the proliferation of guidelines which they blame for a culture of cookie-cutter care that’s bereft of art and flexibility.”

“As lamentable as the loss of the NGC would be for doctors and patients, it’s hardly surprising. Its parent agency has been suffering death by 1,000 cuts for years. Despite a modest bump in its 2018 funding, the AHRQ’s $334 million annual budget is $120 million below its 2010 level, adjusted for inflation,” the report said.

The NGC itself had been consuming $1.2 million a year.

“The decision to end support for the NGC was an agency decision based on assessing how best to use our current resources, including both appropriated dollars and dollars from the Patient-Centered Outcomes Research Trust Fund,” the AHRQ spokesman told STAT.


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