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To: Big Bureaucracy

My experience with doctors that preach “evidence based medicine” is that “evidence” is what they consider “evidence”, namely test results, plus clinical signs, which are responses from patients that can be seen or felt or measured by the doctor. Notably absent as “evidence” for such docs are clinical symptoms, namely that which a patient describes orally, such as, “Doc, I wake up screaming from pain at night.” Nothing the patient says is meaningful to an “evidence” based doctor.

In point of fact, such doctors simply approach medicine as if they were a veterinary for humans, treating the patient is incapable of providing any useful information. On more than one occasion, I’ve actually had such a doctor try to get me to cease effective therapy so that they could “see with their own eyes” the original signs and look at the results of new tests after the therapy ceased, because otherwise they had no “evidence” that I had actually been ill without the therapy!

Should a doctor describe themself as “evidence based”, you should run screaming from the exam room. OK, actually, you should just politely put your clothes back on and leave. Hopefully, you’ve established whether a doc is “evidence based” prior to the doc actually spending any time with you, at which point you should request that no bill be prepared, whether it is an insurance bill or not.


5 posted on 07/31/2010 4:36:18 PM PDT by catnipman (Cat Nipman: Made from the Right Stuff!)
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To: catnipman

That is exactly the point. Evidence based care treats the patients like statistics not like individuals.


6 posted on 07/31/2010 4:44:15 PM PDT by Big Bureaucracy
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To: catnipman

Nursing is now stressing “evidence based” practice as well. Ok so maybe it might be nice to have research to support all of the things we have been doing for years, or to prove that they may not be as therapeutic as we once thought. But the real impact on the bedside nurse is we have reams of paper with check boxes to score and to add up to a total which will tell us how to care for the patient. HUH?!?

For instance in our facility we have a 5 page care plan just for skin integrity. 5 pages! Everyday! For all of your patients! In the amount of time spent on the damn thing I could be actually doing what the damn thing says should be done. Personally I consider the thing an insult to my intelligence. I was taught how to do care for at risk patients 20 years ago in CNA school. It has never failed me.

Then on top of that the facility is spent a ton of money trying to retrain everyone so new grads will have “instinct”. But to me “nursing instinct” is the opposite of “evidence based practice” as it is subjective in nature.


13 posted on 07/31/2010 8:29:38 PM PDT by gracie1 (visualize whirled peas)
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