Led by John Wennberg at Dartmouth, a group of academics have long shown that practice variation in the US between different regions is extreme. In addition, a study from RAND a couple of years back showed that physicians only followed evidence-based medicine in their treatment decisions roughly half the time. Critics have argued that the US should have a central clinical body laying down national guidelines that physicians should be encouraged or even forced to follow.
That is the case in the UK, where the National Institute for Clinical Excellence (NICE) sets out treatment guidelines, including which drugs should and should not be used. However, last week the UK's Audit Commission found that 75 percent of hospitals were not always following the guidelines and were in general erring on the side of saving money by using cheaper treatments than the more expensive, newer drugs that NICE had approved.
- see the story from the Times