David Sackett's Unintended Impacts on Health Policy.

Abstract

David (Dave) Sackett’s death in May 2015 prompted much public reflection about his legacy for the practice of medicine, yet his legacy extends well beyond clinical practice to the fields of public health and health systems and the broad domain of health policy, including policies for clinical care (eg, listing prescription drugs on a public formulary), policies for public health (eg, mandating immunizations for toddlers), and policies for health systems (eg, setting the scope of practice for pharmacists). All these were topics that Dave never addressed directly, although many others did address them using approaches that he had pioneered or championed. Our focus here is on Dave’s legacy for health policy, which was, as far as either of us knows, both unintended and unappreciated by him. We cite 4 examples of how Dave’s contributions to the evidence-based medicine (EBM) movement1—which he would be the first to acknowledge that he made alongside many other giants in the field (a number of whom he trained and mentored)—cleared the path for what became the pursuit of evidence-informed health policymaking.