Important update next day: see comment below by Michael Porembra (and my reply) with new source information and important data on changes in rate of adoption.
A tweet from South By Southwest by @DVanSickle led me to finally post this, which I dug up last spring with the help of the ever-awesome @TedEytan of Kaiser. It’s part of my presentation at the Kanter Family Foundation’s confab last May for their Learning Health System initiative. (Video of that speech is here.)
The issue is a statistic often quoted by advocates for improving medicine: “On average it takes 17 years for new practices to be adopted.” That’s pretty shocking – the idea that some docs may not know something important to your college-age kid, even if the info came out when that kid was in diapers!
The source turns out to be a paper published by the Institute of Medicine in their Yearbook of Medical Informatics 2000. I’ve been unable to locate the full text online; somebody (Ted?) emailed me a scan, from which I screen-grabbed the excerpt in this slide.
People always ask “Is it still true?”
I don’t know of an update – if you do, please add it in a comment! See important update to this in comments.
But I’ll say this: people are pretty much in denial. They asked the same thing about the IOM’s 1999 report “To Err is Human” (the report with the famous statistic “up to 98,000 accidental deaths a year in US hospitals”), saying “Things must have improved since then.” But every single paper I’ve seen on the subject has said the rate of fatal errors (and serious non-fatal ones) is no better today.
The truth is, things like this are system problems, and system problems don’t go away spontaneously – you have to address the systemic issues, or things stay on track, just as if they had a gyroscope. Update: I now say this observation has to be paired with the trend in the comment below.
But an important reality is that doctors (at least in America) are often burdened with enough work that it’s hard to keep up. (The average primary physician in the US has 1500-2000 patients, according to Paul Grundy MD of IBM. Imagine how many conditions they’re supposed to stay current on!) That’s why my TEDx talk ends with the chant:
Let Patients Help!
To me this is yet another example of how empowering and informing patients can improve medicine at very little cost.
I say: we need a website StandardsOfCare.org, and we need to tell every patient and caregiver to look there: “Know your standard of care. Bring it to your doctor’s attention.”
I acquired the domain last year. Anyone want to create a project to populate it??