The Decision Making Process For Patient Care

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As psychologists, we are not degreed Witch Doctors.

Although there are segments of the population that think we are.

‘Clinical Expertise’ – By: Geoffrey M. Reed:

The main thrust of Reed’s position paper is a discussion concerning ‘Evidence Based Practice’ (EBP), viewed by those in the psychology field as a three legged stool, consisting of the integration of: ‘Clinical Expertise’; ‘Patient Values’; and ‘Best Research Evidence’. All of which are incorporated into the decision making process for patient care.

A profound point the author brings up is the concept of ‘A Public Problem Idea’. Which is an idea describing a public problem and a means of trying to solve it by a particular response. Because of the soaring costs of health care, the ‘Public Problem Idea’ is finding ways of reducing these escalating costs. There are those who see the problem as ‘Uninformed Medical Practices’, and the suggestion (Solution?) is to rely to a great degree on EBPs to bring a uniform solution to each form – In our case the mental health field, a diagnosis based upon EBP findings for each psychological illness. Medicare and HMOs love this as EBPs are based on empirical research – Leading to a scientific conclusion of a ‘One size fits all’ cost cutter.

What is troubling to Reed, and to me, is the technique of using EBPs is the easy way out, especially prescribing medications as a first resort. Both he and I believe that the clinician should treat each patient as a unique
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