A Great Example of Why We Spend Twice as Much on Healthcare and Don’t Live as Long!
A Great Example of Why We Spend Twice as Much on Healthcare and Don’t Live as Long!
Below is a quote from the UK NICE guidelines for stable angina. As you can see, they specifically recommend optimal medical treatment (OMT) as the first treatment and reserve a procedure to open the artery only for patients who have intolerable pain despite a good trial of OMT. Primary care doctors handle most of the work. OMT first has been the standard of care in the UK for years. Rational approaches based on the evidence are an important reason Europeans live longer for half the impact on gross domestic product. The UK guideline is produced by providers, patients, and other stakeholders. It is brief and highly directive. In comparison, the American guideline is produced by cardiologists and is not nearly as useful. Here is the good news. American guidelines finally recommend OMT first as the standard of care as of 2020. Very few American healthcare providers are prepared to consistently provide OMT.
https://www.nice.org.uk/guidance/cg126
https://www.nice.org.uk/guidance/cg126/resources/stable-angina-management-pdf-35109453262021 (see page 14)
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1.5 Investigation and revascularisation
People with stable angina whose symptoms are not satisfactorily
controlled with optimal medical treatment.
1.5.1 Consider revascularisation (coronary artery bypass graft [CABG] or
percutaneous coronary intervention [PCI]) for people with stable angina whose
symptoms are not satisfactorily controlled with optimal medical treatment.