Thursday, March 06, 2008

What Doctors Don't Know (Almost Everything)

What Doctors Don't Know (Almost Everything): "It isn't clear that patients will embrace evidence-based medicine. Human beings are social creatures, and we don't necessarily want to have to make up our own minds about absolutely everything, especially if doing so requires trips to the library and afternoons on the Internet and hours of reflection.

The most radical change E.B.M. proposes will occur in everyday visits in doctor's offices -- those simple, scary moments when the most important medical decisions are made. The instant the practitioner stops saying, ''I think you should take this therapy,'' and starts saying, ''The evidence is that this therapy will work this percent of the time, with these complications, this frequently; what do you want to do?'' then the power hierarchy of doctor over patient is collapsed, and autonomy is assigned to the patient. This is how the relationship between doctor and patient could be changed by evidence-based medicine. Just as the idea of authority within medicine is rejected, so too, the idea of the profession of medicine itself having authority over the patient is rejected. Giving authority to the data, instead of other people, empowers everyone, the movement holds."

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