On the surface “evidence based” medicine (or dentistry) seems so right, so obvious. Yet below the surface is where the demons lie. On the one hand we don’t want quacks wandering off into never never land with false cures that waste money and squander hope. Providing what is “proven” to be the best treatment is obviously good.
The sticky part is who decides what is the best, proven, evidence based protocol? Is it a government committee? Is it an insurance plan? Is it the AMA? Is it the employer buying the insurance? Is it a research center?
As ideal as the concept of “evidence based” medicine seems, treatment by committee is likely to reduce individual options, add politics to the process and stifle innovation.
As a society we want medicine to be innovative, responsive to the individual and seeking new and better ways to achieve success. The price we pay for this is widespread differences in treatments, diverse outcomes and some outright bad ideas.
Ideally the worst procedures are kept in check and the better ones become accepted standards but the process continues. How do we best control and guide this process? I don’t have a final answer. In medicine, where this is a much bigger deal than in dentistry, there are people of goodwill working on the problem. However I don’t think the manipulation of the process by government control of fees as described in the article linked below is likely to work well.
…medical treatment guidelines and protocols developed by experts, based on the scientific literature — as reported in medical journals and scholarly reports — is “evidence-based.”