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Will Running the Numbers First Violate the Principles of Patient-Centered Care?
- Sandeep Vijan, MD, MS;
- Rodney A. Hayward, MD; and
- Peter Ubel, MD
- From Veterans Affairs Ann Arbor Healthcare System Health Services Research & Development, Ann Arbor, MI 48105.
TO THE EDITOR:
In their recent editorial, Phillips and Twombly (1) suggest that clinical inertia is easily overcome if providers “run the numbers first and deal with blood pressure and glucose before asking about other problems.” Although managing vascular risk factors is important in reducing the risk for diabetes complications, their approach dramatically oversimplifies the realities of clinical care.
Kerr and colleagues (2) show that clinician and patient uncertainty around management of blood pressure is an important determinant of treatment decisions. Uncertainty can take many forms, from belief in the level of evidence supporting guidelines to …
