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The Physician and Evidence-Based Medicine

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Clinical Inertia

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Abstract

This chapter analyzes the principle of Evidence-Based Medicine which was initially aimed at making it so that patients benefit from the best available treatments. Thus Evidence-Based Medicine is supposed to help the physician make decisions in a fundamentally uncertain context, both at the level of diagnosis and of therapeutic choices. However, as the founders of Evidence-Based Medicine repeated time and again, medical decisions should not only rely on science, but also on the characteristics and the wishes of the patient. The second part of the chapter presents a critique of Evidence-Based Medicine, in three parts: (1) What physicians think about it, (2) Methodological criticisms, in particular those concerning the principle of randomized clinical trials, (3) Finally an epistemological criticism, inspired by the work of Donald Schön, The Reflective Practitioner: Evidence-Based Medicine relies on a Technical Rationality which allows one to solve problems, while the real difficulty for physicians in their daily practice is not to solve problems, but to formulate them. Rather than a Technical Rationality, they call upon more complex decision-making processes relying on their experience.

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  1. Avicenne Hospital and Paris 13 University, Sorbonne Paris Cité, Bobigny, France

    Gérard Reach

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Reach, G. (2015). The Physician and Evidence-Based Medicine. In: Clinical Inertia. Springer, Cham. https://doi.org/10.1007/978-3-319-09882-1_5

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  • DOI: https://doi.org/10.1007/978-3-319-09882-1_5

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