Whats The Evidence (or Why Are You Giving Me That Drug??)

Decisions about what to do given a set of symptoms and signs is one of the most important functions that a physician performs. In recent years, more attention has been given in the medical literature to ways to synthesize the available scientific data and make medical decisions. The formal study of how to determine which decision is right based on the available literature is called Evidence Based Medicine, or EBM. EBM has been used to evaluate many controversial, and formerly controversial issues, including hormone replacement, the use of certain medications in heart disease and diabetes, and cancer prevention. EBM holds out the promise that it will cut the number of unnecessary tests and increase adherence to practices that will actually promote health.

Having said that, EBM can be a double edged sword. As well described in an article in this week's Time Magazine, EBM is often perceived of taking the "art" out of medicine and also making it less humanistic and more mechanistic and impersonal. Also, for ethical or practical reasons, EBM can't answer all the questions doctors would like to answer.

As a physician, it is important to keep up with EBM, and using proprietary software, at Westside Medical we do. Having said that, many of the questions that face the primary care physician, particularly in the area of acute care, are not fully answered and need the art of medicine as well as the science.