Study for a test and you’ll earn a good grade. 

Follow the recipe and you’ll get a moist cake.

Water your garden and you’ll have luscious bouquets.

These instructions are almost innate truths to our lives: If-Then statements that make sense and we accept as the standard because they are time-tested, well-experimented paths to success in school, baking and gardening. We know that water helps plants grow because it has been researched. We know that a cup of flour instead of two cups for a recipe yields a better tasting product because it’s been tested. We can see from the A written in red at the top of test (or are children’s) that studying paid off. We accept these practices because they are standards.

Researchers are finding that some standards-of-care in the world of medicine have become the so-called standard without clinical guidelines, hard data or evidence. According to a New York Times article in December, a report in The Journal of the American Medical Association found that only about a third of clinical guidelines reviewed current medical evidence and fewer than half followed any kind of standard format.

The gap created by the failure to include and study evidence and standards posits a scary situation for patients because evidence-based guidelines are critical to protecting public health from bad medicine. You wouldn’t want to serve a cake with unmeasured ingredients to your friends just like you wouldn’t want to serve your patients via guidelines that lack evidence.

 In standardizing care through pay-for-performance incentives, large insurers like Medicare may increasingly reward doctors for following clinical guidelines. Before that happens, though, it will be critical to establish better standards for the standards — especially for children. Collaborating with an independent review organization like AllMed can help doctors and payers know what the evidence-based guidelines and standards-of-care for a breadth of medical diseases are. 

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