Volume 195 - Issue 11
The dangers of dogma in medicine
Author: Deborah J Verran
Med J Aust 2011; 195 (11): 663. || doi: 10.5694/mja11.11303
Published online: 12 December 2011
Published online: 12 December 2011
To The Editor: Bellomo quite rightly points out that medicine is now in an era when it is recognised that the amount of evidence being generated far surpasses most individual doctors’ ability to adequately deal with it.1 He suggests that “knowledge management may now be one of the major challenges of modern medicine”. However, is this a problem only needing to be confronted by those in medicine?
I would suggest that it needs to be confronted by the Australian health care system as a whole, because a learning health care system is attainable only through implementation of system-wide change.2 In the recent final report of the National Health and Hospitals Reform Commission, three out of the five levers for action required to create an agile and self-improving health system involve elements of knowledge management.3 Hence, there is now much that needs to be done to achieve appropriate knowledge management across the Australian health care sector.
We first need to recognise that knowledge is not only evidence that is gleaned from scientific studies (explicit knowledge) but also involves knowing what others are doing (tacit knowledge), as well as building on experience.4 The term “knowledge management” refers to the capacity to manage all of this at an organisational level.
Further, we need to determine whether knowledge management is a problem that can only be solved within Australia by more resources being given to national bodies,1 or whether more innovative approaches are required. As knowledge management is now an issue for all organisations in the health sector, there is much to be gained from adopting an organisational learning focus2-4 as well as by understanding that an alteration in values (and culture) is required.4,5 Widespread acceptance of the need to identify and disseminate best practices will be required, even if it involves using evidence from international organisations to prevent both redundancy and duplication of effort locally.2,4
Competing interests
No relevant disclosures.
References
- Bellomo R. The dangers of dogma in medicine. Med J Aust 2011; 195: 372-373. 0_i1142882
- Grossman C, Goolsby WA, Olsen L, McGinnis JM. Engineering a learning healthcare system: a look at the future. Workshop summary. Washington, DC: National Academies Press, 2011. http://www.nap.edu/catalog.php?record_id=12213 (accessed Oct 2011).
- National Health and Hospitals Reform Commission. A healthier future for all Australians: final report June 2009. Chapter 5. Creating an agile and self improving health system. Canberra: Department of Health and Ageing, 2009. http://www.health.gov.au/internet/main/publishing.nsf/Content/nhhrc-report (accessed Oct 2011).
- Muir Gray JA. Evidence-based healthcare and public health. 3rd ed. United Kingdom: Churchill Livingstone, 2009. 0_i1142888
- Braithwaite J, Skinner CA, Doeng ML. A values-based health system. Med J Aust 2011; 194: 259-262. 0_i1142890