A debate with Vinay Prasad on the value of clinical practice and the training of doctors

12 Apr
Jordi Varela

Vinay Prasad (University of Oregon) and Adam Cifu (University of Chicago), authors of Ending Medical Reversal: Improving Outcomes, Saving Lives (John Hopkins University Press, 2015), highlight 146 clinical practices that should be stopped because it has been shown that they do not achieve that which they set out to do. The list of these practices affects the whole range of health activities, but on reading more closely, there are four specialities that stand out: cardiology, gynaecology, orthopaedics and family medicine.

It is for this reason that the Clinical Management Section of the Catalan Society of Health Management has organised, by agreement with the Essencial Project of the AQuAS, a debate with one of the authors of the book, Vinay Prasad, and representatives of the 4 specialities mentioned previously. It is to be held at their Annual Meeting next 18 May with the participation of: Xavier Viñolas, president of the Catalan Society of Cardiology, Juan José Espinós, gynaecologist at the Hospital Sant Pau, Joan Miquel, orthopaedist at the Hospital of Igualada and Marta Expósito of the Catalan Society of Family and Community Medicine.

Vinay Prasad

The aim of the debate, which will be moderated by Sandra García Armesto, director of the Aragonese Institute of Health Sciences (IACS), is not only to get to know the work of Vinay Prasad firsthand but also to know what the related specialists think about these practices and what their impact is in our environment, in so many aspects different to that of the United States.

On the other hand, Prasad and Cifu propose in their book to modify the training programmes in medical faculties in a significant way, with the aim of training up new doctors who are more demanding of scientific rigour, more critical of low-value practices, more sensitive to the needs of patients and more oriented towards the assessment of results. The proposed formula is very simple: clinical sciences should be a priority, while basic sciences (as we understand them today) should be complementary.

It is not about studying models first to later verify them (present system), but rather doing it the other way round: based on clinical learning, theories should be reviewed (or accepted).

Given the importance of the proposal, we thought it appropriate to organise a second debate, within the framework of the meeting itself, moderated by Xavier Bayona, with the participation of three academic authorities in the training of doctors: Francesc Cardellach (University of Barcelona), Ramon Pujol (University of Vic) and Milagros García Barbero, president of the Spanish Society of Medical Education, and of course, logically, inviting Vinay Prasad to join in.

The programme for the Meeting is attached, with the clear aim of encouraging all the readers of this blog to register for it because the opportunity to listen to and make questions to Vinay Prasad, and all the invited speakers, should not be missed.

Post by Jordi Varela, president of the Clinical Management Section of the Catalan Society of Health Management.

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