Viewpoint

Moving beyond evidence-based medicine

Stephen G Henry, Richard M. Zaner, Robert S. Dittus

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

The evidence-based medicine movement has remained both well known and controversial since its inception. The authors reframe the evidence-based medicine debate by pointing out an underappreciated epistemological deficiency: evidence-based medicine as currently conceptualized cannot accommodate concepts that resist quantitative analysis and therefore cannot logically differentiate human beings from complex machines. The authors use Michael Polanyi's philosophy of tacit knowing (which refers to the taken-for-granted knowledge at the periphery ofattention that allows persons to understand the world and discern meaning in it) as a starting point for rectifying this deficiency and for working towards an improved, person-centered epistemology of medical practice. The authors demonstrate that not only evidence-based medicine but also most traditional theories of medical practice need a concept such as tacit knowing to account for the kinds of knowledge human beings actually use. Polanyi's philosophy of tacit knowing is defined and briefly explained. A medical epistemology that can account for the tacit dimension of human knowledge and recognize physicians and patients as persons requires a revised conception of medical uncertainty and a recognition that clinician-patient interactions are central to medicine. The authors discuss practical implications of tacit knowing for medical practice, education, research, and health care policy and suggest ways for moving beyond evidence-based medicine towards a comprehensive epistemology of medical practice.

Original languageEnglish (US)
Pages (from-to)292-297
Number of pages6
JournalAcademic Medicine
Volume82
Issue number3
DOIs
StatePublished - Mar 2007
Externally publishedYes

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Evidence-Based Medicine
medicine
medical practice
human being
epistemology
evidence
Health Policy
Medical Education
Uncertainty
Medicine
Physicians
physician
uncertainty
health care
Research
interaction
education

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Education

Cite this

Viewpoint : Moving beyond evidence-based medicine. / Henry, Stephen G; Zaner, Richard M.; Dittus, Robert S.

In: Academic Medicine, Vol. 82, No. 3, 03.2007, p. 292-297.

Research output: Contribution to journalArticle

Henry, Stephen G ; Zaner, Richard M. ; Dittus, Robert S. / Viewpoint : Moving beyond evidence-based medicine. In: Academic Medicine. 2007 ; Vol. 82, No. 3. pp. 292-297.
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