Monday, March 26, 2018

What IS the guideline?

The Canadian Task Force's recommendations on diseases screening has been taught to my class throughout our medical school. Especially for me, as I'll be pursuing family medicine, it has been a very commonly referenced resource by me and many physicians I have worked with. Although most of the time, the recommendations are in agreement with what is practiced, there are also suggestions that don't quite sit well with all physicians.

During my endoscopy clinic today, the resident and staff both informed me how their specialty of Gastroenterology still recommends colonoscopy as a screening tool, despite the Canadian Task Force stating otherwise. When I hear conflicting information such as this, I wonder what choices I will end up making when I am practicing independently. I think this is when it's important to try and understand what priorities lie behind the guidelines I am reading. For example, the Canadian Task Force's guidelines are not only based on population studies, but also taking into account, economic efficiencies. Therefore, from its point of view, a colonoscopy is not the most cost-efficient tool for screening purposes, but from a physician's point of view, it is the best method of finding any pathology within the GI tract.

This is something I believe medical students should be taught, to accurately weigh the pros and cons of each recommendation they reference so that they can make choices that are most beneficial to each patient. Since we're taught to know the "guidelines" to pass exams, it should be made clear to us as learners, what really matters in real-life practice.

-SC-

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