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Well, I disagree with that generalisation. A good doctor makes decisions based on evidence (symptoms of the patient, proven effect of the treatment) as well as experience as a doctor.

When "verifying things on your own" you run into all kinds of unfounded and delusional ravings on the internet. Doctors may err on the side of conventional wisdom, but that's not a call to disregard them and err on any nonsense that you come aross.



Then why do most doctors reject evidence based medicine?


Do most doctors reject evidence based medicine? Do you have a reference or citation for that assertion?


I presume you're talking about "evidence based medicine" the right wing medical reform movement, not all medicine based on evidence. Because while many doctors reject that movement, few seem to reject using evidence to pick treatment regimes.


Is it really right wing? Why? I've just read multiple articles about how slow Dr's are to adopt it even though, empirically, it is more effective. I figured they rejected it for the same reason people always reject things: "that's the way we've always done it".

Now granted, those articles could have been biased, but I had no idea there was any sort of left wing vs right wing thing going on. Stupid politrix.

The entire movement reminded me of Moneyball by Michael Lewis.


There are, of course, a few doctors who reject the very idea that mere scientific evidence should be able to tell them what to do. But in general, most doctors want to provide the best care they can for their patients, and that includes scientific evidence.

However, it's extremely common for doctors to prescribe medicine off-label, before the full level three trials have completed for that use (which can take a decade). There is often compelling evidence a medicine is effective (in the Bayesian sense) far before there is official "Evidence" which counts for "Evidence Based Medicine".

The very fact that it's called "Evidence Based Medicine" should set off alarm bells. Being against it sounds like being against science in medicine, which would just be stupid. In fact, it's code for "restrict public care facilities from being able to offer a full range of medical benefits to conserve money".


Thanks for the information. I seriously thought it was much more like the Moneyball situation where it was just a bunch of old schoolers not accepting reality & empirical evidence and instead relying on standard practices and conventional wisdom.

P.S. We just fully implemented Twisted at TicketStumbler :) (I heard you guys use it, and love it, at Justin.TV).


I'm sure there's some of that too :).

Twisted really is awesome; we've been super happy with it. A little sad they wouldn't take our memcache get_multi patch (they said we hadn't written enough tests for it).


"Evidence-based medicine (EBM) aims to apply evidence gained from the scientific method to certain parts of medical practice." - wkipedia.

What on earth is "right-wing" about that?


Nothing! But many right wing policies are pushed in the name of EBM; in practice it's been used to cut down on medical options for the poor.

Everyone should of course be for applying scientific evidence to medical practice.


Is that a feature of USA'ian health politics (which I don;t follow that closely), or does it happen here in the Uk too?


This is complicated by the fact that most doctors don't know jack squat about statistics. Since most medical data nowadays is collected through statistical means you end up witht he embarrassing situation where a economist or a mathematician would be better informed about a subject if it were not for the constant attention a doctor pays to it.




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