The Baby and Bathwater of Evidence Based Practice


 

One of the principal criticisms of some of the complementary medicine therapies is that we don’t have sufficient science to back up our clinical decisions. The historical or anecdotal evidence which forms the basis of our clinical practice as acupuncturists and Chinese Medicine practitioners, is in many cases dismissed by scientists as being of no scientific value.

I disagree with this theory and think that it’s very much a case of throwing the baby out with the bathwater. Life is not all absolutes and the older I get the more I realise historical clinical experiences transcribed faithfully by past clinicians benefit and inform our current practice, and can become the basis of a wider model of EBM even if they don’t meet the current scientific criteria of the clinical trial.

I disagree with this theory and think that it’s very much a case of throwing the baby out with the bathwater.

A strict EBM formula i.e. the same formula applied to each case goes against the individualisation and flexibility of aspects of TCM treatments. Acupuncturists and Chinese Medicine practitioners constantly reference previously documented clinical decisions witin the practice. We test the theories and that is the value of anecdotal evidence.

We do of course need good research to further test theories, but that cannot be heralded as the only measure of clinical effect, so much so that we begin to discount historical, anecdotal evidence.

Let’s keep the baby in the bath when we throw out the bathwater.

Reference: Friedland et al “Evidence Based Medicine, A Framework For Clinical Practice”. McGraw Hill, US (1998)