Day 9 was very slow. We had worked on discharging all of our patients for Christmas. We succeeded.
Today we are admitting, and I expect several admissions. Many patients hold off prior to Christmas, so the ER is often busy.
15 days at the VA – day 9
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One of the problems, as you state, is that EBM cannot be followed blindly. However, EBM at least attempts to make sure physicians that physicians can review the evidence rather than relying on industry-sponsored information.
Unfortunately, it takes time to ferret out the unbiased facts. Take, for example, the issue of whether intensive control of plasma glucose (as measured by HgbA1c) leads to fewer cardiovascular events compared to standard therapy. There is quite a debate going on now in the medical literature. Realistically, do most physicians have the time to track down, read and evaluate the five key studies (e.g. ACCORD, UKPDS) that address this issue? And do most doctors even know there is a debate going on because it’s an issue that you might not hear much about unless you seek out the information.