How Does Your Medical Provider know what to do??

Ever wonder how experts become experts?  Like, how does the world’s foremost Dinosaur Paleontologist become that? Well, I can guess she reads a lot. (For the sake of this example we’ll just assume it’s a she.  Cuz science and all…).   She has studied long and hard.  She talks with other experts.  She attends conferences all about dino bones.  And I’m willing to bet ANYTHING she continues to read and study.  She didn’t just do her post graduate thesis then not learn anymore.  This lady lives, eats, breathes dino bones.  And as a scientist she will continue to learn her whole life.

Wonder where I’m going with this?  C’mon, its not that hard y’all.   Science, and in particular medicine, are sports for life long learners.  Let’s dive deeper into what I mean. 

Medical providers, like doctors, physician assistants and nurse practitioners are required to earn “continuing medical education” hour, or CME’s.  I know the rules about PAs, we’re required to earn 100 hours of CME every other year.  There are some particulars about how we earn the credits, we need to take certain courses in Opiate and Controlled Substances….yadda yadda yadda.  But the point I want to stress is we’re required to take some classes.  However, I will say that most of us medical providers do way, way, way more than that.  We talk with peers, we consult experts, we read scientific journals, we look stuff up. 

White Coat Cody

Oh, do we look stuff up.  Some things I kinda know but I can’t quite remember.  For instance, I can never remember antiviral dosing, so I looked that junk up all the time.  But I also look up anything I just don’t know.  Recently I’ve looked up Gonorrhea treatment when you’re allergic to the main drug used.  I looked up what antibiotic to prescribe when someone has a rooster beak injury (Augmentin, in case you’re wondering..).  I had to search for treatment of oral bleeding ulcers when the patient is on blood thinners. 

Its impossible to learn (or retain) EVERYTHING during school.  But we’re scientists, and we already established scientists want to be lifelong learners.  But there’s one more thing – we want to do what’s best for our patients.  So we look at credible sources and we base our medical decisions on evidence.  This is the stuff scientists love, reproducible results!  There is a big push in medicine to get rid of tradition and practice Evidence Based Medicine, EBM

Evidence based medicine is a fancy way of saying – we practice the best medicine we know how.  A big fancy article written by David Sackett and then cited by 9,000 other people writes the EBM: “is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”  Lets break that down: It means medical providers actively seek out best practices to the make the best decisions for individual patients.  (wanna read that article?  I know you’re dying to.  Find it here.)

So why the big push towards EBM (Evidence based medicine)?  Well, EBM makes it so a lot of aspects of medicine are standardized, meaning every patient is treated the same way.  Remember when I couldn’t quite recall antiviral dosing?  Instead of guessing I look it up and every patient with Shingles gets the same, proven dose.  It also sets measurement points so providers know how they’re doing.  In short, it provides more data.  And we’re scientists, we love data. 

With this blog post, and with my blog in general I hope to make medicine very approachable.  I want every patient to feel empowered!  So I wanted to take you inside how we practice.  It’s not that exciting – basically we sit around and read medical journals or informative articles from a few select sources.  For instance I have an app on my phone that is a huge medical database, its called Up To Date.  The annual is subscription is about $500! Sometimes offices pay for the subscription, sometimes provider pays privately.  Anyways it tracks how much I read, right now I’ve looked up about 260 hours worth of CMEs.  And that doesn’t include podcasts, books, journal articles or peer discussion regarding medicine. 

My photographer called this picture “More degrees than a thermometer…”

So all this is to say – medical providers aren’t just picking diagnoses and treatment out of the air.  We base decisions on a lifetime of learning.  And because we genuinely want the best outcomes for our patients, we base all of our decisions on evidence! 

Have any questions about me, the medical decision-making process or evidence based medicine?  Have any questions about Healthyish?  Hit me up at ceccard@gmail.com  I’m a one woman show so it’ll be me answering your emails!  Also sign up for the best email list in town!  I’m focused on breaking medicine down to give you info about physical but also mental well being,  Sign up right here:

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