The phrase “evidence-based medicine” is pervasive in health care now. As the phrase becomes more and more common, there seems to be a growing chasm between those that utilize the scientific method, and those that don’t. It’s creating a rather intriguing problem for patients and practitioners.
In one corner, we have those that are utilizing evidence-based strategies in the care of the patient. Using the scientific method doesn’t eliminate what many call “the art of health care”. The clinician still has to have clinical reasoning skills (which are deeply rooted in the scientific method) and the ability to use their communication skills effectively to establish rapport with the patient.
In the other corner, we have the “gurus”. These are the people that will tell fellow providers that science has yet to explain what they do and besides, it doesn’t matter anyways. Experience is critical, and there are plenty of stunning anecdotal results that make it all the more obvious. The “gurus” are the ones armed with methods that have minimal scientific plausibility as a foundation. And when speaking to other practitioners eager to learn their “methods”, they will be the same people that will proclaim that one could be so lucky to attain their level of understanding, unless of course you want to take their 3 week course and pay a few thousand dollars to do so.
And though we might have once thought that the gurus were exclusively found amongst practitioners of “complementary and alternative medicine”, they are now rampant amongst “mainstream” health care providers (such as physicians and physical therapists).
But here’s the problem: you can’t live in a world in which you selectively choose when you want to live with evidence and science, and when you don’t. You cannot ride the coat tails of science while advocating for the cult of personality, mysticism, or the power of the placebo.
So do I need evidence? And why does it matter anyways?
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