Clinical Judgement & Evidence-Based Medicine: Time for Reconciliation (Report)
Clinicians in the traditional mold, and more recently trained physicians who subscribe to the tenets of evidence-based medicine (EBM), often hold diametrically opposite viewpoints when making patient management decisions. These differences of opinion often appear irreconcilable and cause considerable animosity between otherwise well-intentioned professionals. Arguments are designed to pit the nebulous notion of “clinical judgment” against a loosely defined concept of EBM. In scientific meetings and teaching sessions at academic institutions where these exchanges most often occur, these discussions provide for much entertainment by emphasizing extreme and unrealistic scenarios, but contribute little towards offering any insight or clarification. An appreciation of the true meaning of what both “clinical judgment” and “EBM” stand for is essential to understanding, and hopefully, resolving this unpleasant standoff. The divide between “clinical judgment” and “EBM” is in fact nonexistent and is the result of a lack of understanding of what these terms actually represent (1). What is clinical judgement?