The idea of QuestioningMedicine came up during group rounds with fellow residents and hospitalist. As we sat there and discussed the need for ordering multiple tests and interventions, we wondered why seemingly straightforward cases gave rise to so many varying opinions.
Not only did it seem that each attending had a slightly different take on each case, they themselves would change plans on similar diagnoses a few days later. The consistent inconsistencies led to frustration-rounds devolved into guessing each attending’s idiosyncrasies which were erratic unto themselves.
The inevitable question arose: ”Why are we doing this?”
We sought replicable standards, the “mass customization” that quality wonks will frequently speak of.
Our search led us to the old standbys: UpToDate, Medscape, Harrison’s, and multiple national guidelines. This led to even more uncertainty. Guidelines and recommendations often were conflicting, dated, or otherwise incomplete. Many suggestions were expert opinions- “based on my experience, this will work, so you should do it.”
In the era of transparency (pardon the trendy but overly used cliché), we thought that maybe there was a better way.
We dug deeply into the most current research and found that the way we have been practicing medicine may not, in fact, be “evidence-based medicine.”
When our attendings would ask us to bring our findings to the table, we found that we were able to grant our patients excellence in care, removing some of the individual variability in favor of large scale evidence based trials.
Our goal is to provide easy, reliable access and contribute to the movement that is “Free Online Access to Medical Education” or FOAMed.