What's wrong in this scenario* is that Dr Zen's practice has been hijacked by guidelines, economic imperatives and intrusive technologies. Evidence-based medicine may be a comfort to Zen in the five minutes she has and may improve the look of the annual report of Corporation Enterprise, but the value of her skilled interpretation of the patient's narrative has been ignored. She remains a world away from her patient, with little time to weigh and integrate the research evidence on her screen. Algorithms and hospital-based trials cannot care compassionately for a man grieving for his lost wife, but narrative-based research may provide guidance.
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 1 Department of General Practice, University of Adelaide, Adelaide, SA.
- 2 Department of General Practice, University of Melbourne, Carlton, VIC.
- 1. Ham C. Improving the performance of health services: the role of clinical leadership. Available at: http: //image.thelancet.com/extras/02art8342web.pdf (accessed April, 2003).
- 2. Sackett D, Rosenberg W, Gray J, et al. Evidence based medicine: what it is and what it isn't [comment]. BMJ 1996; 312: 71-72.
- 3. Beilby J, Marley J, Walker D, et al. Effect of changes in antibiotic prescribing on patient outcomes in a community setting: a natural experiment in Australia. Clin Infect Dis 2002; 34: 55-64.
- 4. Bowling A. Research methods in health. Investigating health and health services. Maidenhead, UK: Open University Press, 1997.
- 5. Wensing M, Elwyn G. Improving the quality of health care. Methods for incorporating patients' views in health care. BMJ 2003; 326: 877-879.