Great ideas here! David you ve been so thorough and realistic in your argument not supporting EBM as the Pinacea of medicine. As much as i may share with your line of argument i would prefer to stay on both side as Zoe.
i was reading about the confusion between the use of paracetamol or Ibuprofen and Ibuprofen and paracetamol in treating fever in children. The application of EBM through a clinical trial showed that combination of ibuprofen and paracetamol reliefs fever faster than paracetamol alone. This resulted in establishement of a guildline which a doctor will embrace with ease. Some components of EBM is the bane of pharmacy practice now interms of drug production and dispensing.
www.medicine.ox.ac.uk/bandolier/painres/download/whatis/ebm.pdf
I wouldn't dispute the fact that patient focussed interviewing is quite helpful at least given a patient some sense of being contributory to solving his health problems and then doctors drawing decisions from patients complain. We should also know that it is at this point in this approaach that quackery sets in in medical practice for incompetent doctors. Such doctors should be at the mercy of EBM guidlines.
i would suggest that the prowess and expertise of doctors in embracing medicine as an art would be needed to play in between these two tensed approaches. this really will finally depends on how good the doctor is.
