Ariel Katz, CEO and cofounder of H1.
getty
The biggest problem with new therapies right now is that most doctors don’t use them. It might sound counterintuitive, but it’s true. The long-standing challenge of adapting clinical practice is a phenomenon well-known to doctors, who have often been labeled “creatures of habit” due to their reluctance to embrace change.
Why wouldn’t doctors use the latest drugs and treatments that have been proven to be effective? The problem isn’t the doctors themselves; it’s that the healthcare system isn’t set up to facilitate the ongoing knowledge transfer that doctors need in order for them to keep up with the latest advances in their therapeutic area. Navigating the ever-evolving world of medical technology can be daunting, and it’s no easy feat for physicians who are already stretched thin in their daily routines. Physicians are truly not afforded the time to stay current on new scientific literature or assess and adopt the latest medical breakthroughs in their field. Even if they were, it would be nearly impossible for them to do so without a mechanism to steer them only to the newest, most relevant research affecting their area of practice.
As important as doctors are, they’re only human. They only have so many hours in a day. They have spouses, children, errands, appointments and other commitments, just like everyone else. When they’re working, they’re looking to maximize time with patients while minimizing the time spent on administrative duties. According to the California Medical Association, citing studies from AMA, Mayo Clinic and Stanford Medicine, “The overall prevalence of burnout among U.S. physicians was 62.8% in 2021 compared with 38.2% in 2020, 43.9% in 2017, 54.4% in 2014, and 45.5% in 2011.” There isn’t enough time for them to stay abreast of all the new medical research and publications being released—which increase every year.
Clinical Inertia
Naturally, doctors will treat patients to the best of their abilities, with the knowledge and experience they have already acquired. However, too many doctors don’t know that some of their knowledge and preferred treatments have become outdated, and they remain unaware of newer and potentially better options. So, doctors unintentionally provide suboptimal care by not changing or updating their practices. This is known as “clinical inertia.”
Take, for example, a certain prescription medicine for treating chronic heart failure. Studies show it significantly reduces the risk of cardiovascular death and hospitalization and can increase life expectancy in patients. You would think this medicine would be top of mind for any practicing cardiologist. But our data shows that the majority of cardiologists aren’t prescribing the drug to patients who would be ideal candidates for it. It’s not that these doctors are deciding against prescribing it; they just don’t know about it or don’t know about its success rate.
The cost of clinical inertia in patient outcomes and dollars is staggering. For example, according to the article “Clinical Inertia and Outpatient Medical Errors” by Patrick J. O’Connor and others, “Clinical inertia in diabetes care may lead to several hundred thousand serious adverse events, billions of dollars of excess health care charges for these events, and tens of thousands of excess deaths per year in the United States alone,” (pg. 296). And as biotechnology advances faster every year, it will only become more difficult for doctors to keep up with the latest and greatest discoveries and therapies.
New Approaches
The medical industry is aware of the growing problem of clinical inertia, and they are taking some steps to mitigate it. Traditionally, medical students would spend their first two years focused on textbook memorization. A number of medical school curricula have been updated so that only the first year is textbook-heavy, with year two shifting to scientific research and inquiry. This new approach was pioneered at Harvard and Johns Hopkins and is becoming more mainstream. It’s a good start, and it’s important to adapt medical practices to accommodate rapidly increasing medical research and innovation. But that still isn’t enough; it won’t add more hours to the day or decrease a physician’s workload.
There are tools and platforms today that can enable a paradigm shift in how healthcare practitioners stay informed about the latest medical research and treatments in a particular field. Rather than doctors subscribing to a newsletter or publication and hoping they’ll find some time to read it, or attending conventions here and there with a limited number of speakers, doctors can receive targeted information and insights gleaned from vast troves of healthcare data, including groundbreaking discoveries from both mainstream and cutting-edge sources all over the world.
This information can be contextualized and connect disparate sources of information, including de-identified patient data, claims data, clinical and scholarly work, published research and key expert opinions. Medical science liaisons (MSLs) can use these granular, data-driven analysis platforms to find the best possible practitioners to prescribe their treatments. When a doctor treats a patient population that would benefit from a new, proven therapy, MSLs can quickly and easily discover and engage with the doctor. This helps the doctor stay up to date and provide the best possible care to patients without having to spend time researching medical journals.
Medical science is only going to accelerate, and the amount of new information is too overwhelming for human doctors to keep up with. In order to advance global health equity and ensure the best possible outcomes for all patients everywhere, healthcare must evolve beyond the textbook approach and embrace a connected, community-based digital approach to spreading knowledge and best practices. Clinical inertia remains a roadblock to health equity, but I’m confident that technology will enable us to overcome this challenge, and the next generation of practitioners will make avoiding clinical inertia part of their everyday practice.
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