Healthcare: Critical Analysis of Evidence-Based Medicine vs. Physician Experience

Healthcare: Critical Analysis of Evidence-Based Medicine vs. Physician Experience

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Healthcare: Critical Analysis of Evidence-Based Medicine vs. Physician Experience


Physician experience in the traditional mold, and more recently trained clinicians who subscribe to the tenets of Evidence Based Medicine (here in referred to as EBM), have more than often held a diametrically contrary opinion towards patient management decisions. The different views derived from these two perspectives seem irreconcilable and has over the time created animosity among well intentioned professions. The appreciation of the actual meaning between the two terms provides a critical understanding on the strength and weakness presented in the clinical arena (Epling,Smucny, Patil &Tudiver, 2002).


The EBM and Physician Experience are fashionable concepts. As such, the terms have more than often been endorsed by medical and pharmacological scholars across the continuum (Ezzo, Bausell, Moerman, Berman & Hadhazy, 2001). To this end, everyone appears to agree that both terms be included in the clinical practice. However, most scholars assert that it is not easy to reconcile the two approaches. This is especially so because the EBM approach is centred on what Ezzo et al. (2001) refer to as randomized clinical trials (RCTs) to come up with the best treatment and at the same time ignoring the outliers. On its part, the physician experience focuses on experienced medicine.

Literature review

Dib, Atallah, & Andriolo (2007) define EBM as form of medicine that focuses on optimizing the decision making process for the purpose of employing evidence from well conducted research.  Even though physician experience exhibits some degree of empirical evidence, Dib et al. (2007) argue that the EBM goes beyond the epistemological evidence. In this regard, findings require the EBM to use strong type of meta-analyses, systematic reviews, and more importantly, use of randomized control trials that leads to strong recommendations. To this end, the approach of EBM plays a critical role in decision making process by individual physicians.

On its part, the physician experience lacks rigor and does not focus on distinct control. In addition, it relies more on anecdotes leaving many open ended questions. In an event where patient’s life and death decision is required, EBM and physician narrow down to specific questions, which, according to Epling et al. (2002), the choice depends on the available data. In Epling et al. (2002) view, the EBM does not take every factor into account and, as such, this approach provides physicians with partial answers to make their decisions. This opinion is cemented in Ezzo et al. (2001) argument opining that even though the EBM has embarked on a series of studies, many have been repeated and offer slight corrections from the previous researches.

The physician experience, according to Gallini, Paul, Archier, E et al. (2012) provide little documentation and, as such, focuses mainly on analogy and pertinent data. The approach provides no blinds to objectivity and thus, is a challenge to know the extent in which physician experience is to be trusted. In Gallini et al’s (2012) views, the EBM is the modern and essential tool that is conscientious, explicit and more fundamentally, it judiciously employs existing evidence to make decisions about the individual patients. The practice between the two approaches as put forward by Gallini et al. (2012) views means integration of clinical experience with the best existing external clinical evidence derived from extensive systematic study.


To this end, the use of EBM incorporates previous physician experience by designing guidelines that are applicable to populations as basis of evidenced centred practice policies. The end results are that the concepts have yielded a broader decision making process employed in the entire healthcare system. Whether employed in medical teaching, the decisions regarding patients, guidelines, administration of medical services towards populations are hinged on the systematic research derived from EBM and not the experience and beliefs of physicians and experts. Therefore, the EBM tend to view physician experience and opinion as limited by knowledge gap and biasness and, thus, is supplemented with evidence derived from scientific literature so that best practices can be put into use.


Ezzo, J., Bausell, B., Moerman, D., Berman, B., Hadhazy, V. (2001). “Reviewing the reviews. How strong is the evidence? How clear are the conclusions?”. Int J Technol Assess Health Care 17 (4) 457–466.

Gallini, A. Paul, C, Archier, E et al. (2012). “Evidence-Based Recommendations on Topical Treatment and Phototherapy of Psoriasis: Systematic Review and Expert Opinion of a Panel of Dermatologists”. Journal of the European Academy of Dermatology and Venerology 26 (Suppl 3): 1–10. doi:10.1111/j.1468-3083.2012.04518

Epling J, Smucny J, Patil A, Tudiver F (2002). “Teaching evidence-based medicine skills through a residency-developed guideline”. Fam Med 34 (9): 646–8.

Dib, P. Atallah, A. Andriolo, R. (2007). “Mapping the Cochrane evidence for decision making in health care”. J Eval Clin Pract 13 (4): 689–92. doi:10.1111/j.1365-2753.2007.00886.



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