“End of the Line” for medical guidelines

Knowledge is king

That’s the take home message from Professor (of pharmacy) James McCormack’s latest parody video, End of the Line, which takes a whack at healthcare’s increasingly pervasive and rigid medical guidelines.


If followed to the letter, these guidelines (often based on research funded by drug companies) would have everyone diagnosed with a disease and taking one or more medications. Medical guidelines may be great for the drug business, but not so much for individualized, patient-centric care and shared decision-making.

Chronic disease state guidelines (blood pressure/lipids/glucose/bone density) do not provide clinicians with enough balanced information to do shared decision-making. This is a problem that needs to be fixed ASAP.

Many well-known leaders in the evidence-based and less-is-more healthcare movement (some of whom I’ve mentioned on this blog) “star” in the video and are shown holding signs that read:

  • Knowledge is king
  • Dare to know
  • Give patients the numbers and let them decide
  • You’re all right
  • You really don’t have a disease
  • Keep calm and don’t blindly follow guidelines

Medical guidelines are, well, guidelines

Used well, medical guidelines can help you and your physician decide what screening tests and treatments are best suited to your healthcare goals. But as the video points out:

Most guidelines ignore your values and preferences and don’t provide balanced information on benefits and harms.

Shared decision-making is about having a real discussion with your health care provider and being a truly informed participant in your care. And research has shown that informed patients choose to use less health care (and save money!)

Knowledge is king. Choose to be an informed patient.

Another of my favorite McCormack parody videos is Bohemian Polypharmacy.

You can also find him at his website, Medication Mythbusters.

And for more information about evidence-based healthcare and shared decision-making, check out my Resources page.


Frugal Nurse

Books by a few of the people featured in the video:


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