Good article, but I feel Atul Gawande mischaracterized "evidence-based practice" in a way that does our whole planet a disservice when he poo-poohed it to lionize Warwick.
Evidence based practice isn't really new, it's been a thing since '92. And while it is about using studies to make treatment decisions, it's not about forbidding doctors from thinking for themselves.
But what really got my goat was the fact that evidence-based medicine is the new thing, and it's an essential step in the evolution of medicine, and more people need to understand it. Evidence based medicine is about applying statistics to determine when treatments cause more harm than good. With modern medicine's advances in imaging techniques, we're hitting all sorts of new and dangerous problems where the benign abnormalities we all accumulate over our lives are treated at great expense, inconvenience and loss of health.
I don't think he was "poo-poohing" it exactly. If everyone only follows evidence based medicine there will never be any improvement because there will never be any changes.
So someone has to be the person who ignores it, who tries new things. And that someone, in this field, is Warwick.
The evidence part comes in when that person also tracks their results! i.e. makes it a study, and Warsick certainly seems to do so.
Yes I got the impression his attitude about evidence-based medicine is similar to that saying about accounting -- that "accounting is the art of looking in the rear view mirror and dragging your ass into the future".
i.e. Accounting isn't worthless. It's necessary, but not sufficient.
Evidence based practice isn't really new, it's been a thing since '92. And while it is about using studies to make treatment decisions, it's not about forbidding doctors from thinking for themselves.
But what really got my goat was the fact that evidence-based medicine is the new thing, and it's an essential step in the evolution of medicine, and more people need to understand it. Evidence based medicine is about applying statistics to determine when treatments cause more harm than good. With modern medicine's advances in imaging techniques, we're hitting all sorts of new and dangerous problems where the benign abnormalities we all accumulate over our lives are treated at great expense, inconvenience and loss of health.