Why standardization?

Why standardization?

By Patricia L. Dawson, MD, PhD, FACS
Breast Cancer Surgeon

You may be hearing more talk about standardization in medicine these days. What does it mean and why is it important to everyone? People who are not in the medical field may worry that standardization will result in their care being less personalized and more “cookie-cutter.” Nothing could be further from the truth.

For several years, medical providers, healthcare administrators, healthcare quality experts and others have been talking about improving medical care and health outcomes through increased use of data and standardization. The term “evidence based medicine” is used to indicate that medical recommendations and decisions are based, to the extent possible, on data – rather than just doing things because they have always been done that way.

Data can be obtained through clinical trials (where patients are randomized to various treatments and then the outcomes are compared), observation (where the outcomes of various treatments are analyzed to see which are more effective), or expert opinion (where experts in the field agree on best treatments based on experience or “best practices”).

Standardization means that patients will be offered treatment based on the best available knowledge. Those treatment recommendations are also influenced by the patient’s individual situation, so that care is personalized.

For breast cancer patients, this may be evident in various ways. We know that most women diagnosed with early stage breast cancer will not have spread of the cancer at the time of diagnosis. That means that doing a lot of “staging” tests, like PET-CT scans or bone scans, is not necessary for most women, because the likelihood of them being abnormal is so low. The avoidance of these tests improves care for women by less radiation exposure, fewer procedures, and less inconvenience. On a larger scale, doing fewer un-necessary tests also means saving healthcare dollars.

Another example of how standardization has helped breast cancer patients is in how the diagnosis is usually made. In the past, most women had their diagnosis made by a surgical biopsy. That meant that many women had surgical removal of breast tissue and then found that they didn’t have cancer. Other women had surgical biopsies but needed additional surgery to treat the identified cancer. Now, most women will be diagnosed by a core needle biopsy – frequently done by the radiologist – using the mammograms or ultrasound to guide the placement of the needle. If the biopsy is benign, many women will not need to have surgery. If the biopsy shows cancer, the treatment can be individualized and planned so that usually only one operation will be necessary.

So what does this all mean for you? When you hear talk of standardization or “best practices” you can feel assured that your providers are trying to give you the best possible care and treatment options.

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