PROMOTING CONSUMERS DEMAND FOR EVIDENCE-BASED MEDICINE

The widespread implementation of rationing and priority-setting polici es in health care opposes the stochastic practice of medicine induced by professional uncertainty and professional vested interests in marke t-oriented clinical environments. It also clashes with consumers' over ly optimistic and ''mythical'' view of the effectiveness of medicine, which is bound to support a potentially unlimited provision of health services, Thus, for consumers and society at large, it is necessary to create conditions favorable for a more conscious demand of evidence-b ased health care. In pursuit of this goal, we suggest the adoption of a community-oriented strategy based upon delivery of information to th e public in order a) to generate greater awareness (''healthy skeptici sm'') among consumers, through disclosure of data on the true effectiv eness of health care interventions and or! the existing variation in t heir utilization, and b) to provide tools to empower consumers in deal ing better with both the uncertainty in their own individual patient-p hysician relationships and with the health policy issues to be faced i n the future. Such a community-oriented strategy could also reinforce and support, through the generation of a ''bottom-up'' pressure from c onsumers toward physicians, a wider adoption of evidence-based interve ntions by health care professionals. This paper, using data from surve ys on public opinions and attitudes toward the practice of medicine, f ocuses on how consumer demand for more evidence-based medical practice can be promoted.