Before making any more comments I should first review the slides
Michael sent, but my point was not that you do away with expertise
( of course we will always need it- otherwise we can close all
schools!) My point was that the goals classic definition of EBM
promote cannot be done in a coherent, rational and repriducible
fashion (regardless if we are talking about expertise vs. experience)
and in fact hurt EBM movement. I personally used to promote the
"classic" definition (and still do as something that we normatively
aspire to) until I realize that every single recommendation made
within the classic EBM framework can be justified (regardless how
irrational or inappropriate that may look to an outside observer). I
too challenge you and anyone else to come up with a single case that
practicing medicine according to the "classic" definition of EBM
cannot be easily challenged.
Best
Ben
Ben Djulbegovic,MD
Professor of Medicine
On Aug 9, 2009, at 8:17 AM, "Piersante Sestini" <[log in to unmask]>
wrote:
> Djulbegovic, Benjamin wrote:
>> Michael, a couple of weeks ago or so, I commented that the
>> "classic" definition of EBM ("the integration of best research
>> evidence with clinical experience and patient values") is
>> inadequate and should change
> As far as I understand, the correct word is "expertise", not
> "experience". They are two related but quite different matters: "being
> an expert" is different from "having experienced".
> You cannot rule expertise and judgment out of practice, as you cannot
> even start to address a problem without them.
>
> regards,
> Piersante Sestini
>
