Should Evidence-Based Medicine Be Replaced By Interpersonal Medicine?

An opinion piece in the New England Journal of Medicine complains about the limitations of evidence-based medicine (EBM) and recommends a new approach they call “interpersonal medicine.” In my opinion, good clinical medicine is already interpersonal medicine; there is no need for something new. The 22 November 2018 issue of The New England Journal of Medicine carried an opinion

Zombie Criticisms of Conventional Medicine

Alternative medicine, by definition, is medicine that is not supported by good enough evidence to have earned it a place in mainstream medicine. Some people insist that modern medicine is not evidence-based either! Not long ago I got an email from a man who said that and tried to prove it with a series of

American Academy of Family Physicians Home Study Course Recommends Non-Science-Based Treatments

Strong medicine…along with a little nonsense Since passing my board exams in family practice in 1979 I have relied heavily on the American Academy of Family Physicians for continuing medical education via the American Family Physician and the AAFP home study programs. The AAFP prides itself on its evidence-based approach to medicine. In general, it delivers. But

The Forerunners of EBM

The term “evidence-based medicine” first appeared in the medical literature in 1992. It quickly became popular and developed into a systematic enterprise. A book by Ulrich Tröhler To Improve the Evidence of Medicine: The 18th century British origins of a critical approach argues that its roots go back to the 1700s in Scotland and England.

“How do you feel about Evidence-Based Medicine?”

That was the question asked on a Medscape Connect discussion I did a double-take. How do you feel? Could anybody object to the idea of basing treatments on evidence? The doctor who started the discussion asked: Besides using EBM, a lot of my prescribing comes from anecdotal experience and intuition. How about you? Where do you get your information from

Evidence-Based Medicine, Tooth Fairy Science, and Cinderella Medicine

The term evidence-based medicine (EBM) first appeared in the medical literature in 1992. There were two previous EBMs: Expert-Based Medicine and Experience-Based Medicine. In the 4th century BCE, Aristotle said men have more teeth than women. He was the expert, and for many centuries his error was perpetuated because no one dared question his authority

Brief Note: The Chiropractic Subluxation is Dead

The General Chiropractic Council, a UK-wide statutory body with regulatory powers, has just published a new position statement on the chiropractic subluxation complex: The chiropractic vertebral subluxation complex is an historical concept but it remains a theoretical model. It is not supported by any clinical research evidence that would allow claims to be made that

Medicine’s Beautiful Idea

For most of human history, doctors have killed their patients more often than they have saved them. An excellent new book, Taking the Medicine: A Short History of Medicine’s Beautiful Idea, and Our Difficulty Swallowing It, by Druin Burch, MD, describes medicine’s bleak past, how better ways of thinking led to modern successes, and how

Polypharmacy – Is It Evidence-Based?

Polypharmacy essentially means taking too many pills. It’s a real problem, especially in the elderly. A family doctor gives an elderly patient one pill for diabetes, another for high blood pressure, and another to lower cholesterol. The patient sees a rheumatologist for his arthritis and gets arthritis pills. Then he sees a psychiatrist for depression