EBM: it’s about evidence, not physicians or patients…

In Uncategorized on November 3, 2009 by Alan Lovell Tagged: , , , , ,

There’s some chatter on the evidence-based healthcare message board about the definition of “evidence based medicine” and I have to say I get a bit fed up sometimes as people always talk of the “holy trinity” of EBM, that of: use of evidence + physicians’ experience + patient choice.

But I mean to say, it’s not really, is it? The practice of medicine is a combination of these things, sure, but evidence-based medicine is all about evidence, not experience and not patient choice. It’s not patient-centric medicine, or experience-based medicine, or authority-based medicine. In fact, it’s explicitly NOT about those things. Physicians have had plenty of authority during the long and slow development of medicine, and stil have much weight to throw about; they still harm patients too (they cure people and alleviate a lot of suffering too – I’m not anti physician – far from it, I think they’re great, particularly when I’m ill – just making the point that they’re not omnipotent). As for patient-centric medicine that is indeed important and, like any business, the client is key; the needs of patients do have to play a role in medicine. But that’s not what evidence-based medicine is about. It’s about evidence, evidence and evidence, it’s about the application of the scientific method to healthcare, and to say otherwise is just to try and sweeten the bitter pill that EBM might be to certain healthcare stakeholder groups.

Long live EBM. Long live science… 🙂


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