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It is not appropriate to dismiss inappropriate care

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Personalised care does not justify use of therapies that have been shown to lack benefit

Will you be disbelieving, dismissive, disheartened or alert to the dangers after reading the study in this issue of the MJA that identified potentially inappropriate care in Australian hospitals?1 Using routine hospital admissions data, Duckett and colleagues found that five procedures not supported by clinical evidence happen more than 100 times a week and there is great variation in hospital-specific rates of procedures that should not be done routinely.

Disbelieving

Confirmation that inappropriate care continues to occur challenges to the core the optimal, ethical and patient-centred medical care that medical professionals strive to provide.2 To disbelieve the findings would be human,3 as “evidence contrary to our personal beliefs tends to be dismissed as unreliable, erroneous or unrepresentative”.4

To counter the discomfort these findings provoke, we may rationalise, arguing that the appropriateness of care is quintessentially where the art and science of medicine merge, where balancing the logic of evidence with the personal values of each individual patient leads to variation in care. However, personalised care does not justify inappropriate care.

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