By Dr. Shawn Thistle
Since launching Research Review Service in 2006, I have realized that the term 'evidence-based' is a source of angst and confusion for many who practice manual medicine - whether chiropractic, physiotherapy, osteopathy, or another related discipline. The concept of basing our patient care solely on what the research 'tells us' we can (or should) do often invokes feelings ranging from inadequacy and uncertainty to anger and resentment. In my opinion, such feelings are unecessary and very counter-productive on both individual and professional levels.
I have always been a proponent of adopting the term 'evidence-informed practice' because I feel it better reflects the reality of knowldege transfer into clinical decision making and patient care. What many forget is that 'evidence-based medicine' (EBM), as it was originally proposed, includes 3 equally important pillars:
1) The best available evidence;
2) experience of the treating clinician; and
3) the preferences of the patient regarding their care.
I feel the term 'EBM' may overemphasize the importance of #1, at the expense of #s 2 and 3.
'Evidence-informed practice' reflects a more realistic scenario where clinicians are aware of emerging evidence, and rationally integrate new information into their clinical acumen, keeping the best interest and desires of the patient in mind at all times. This process occurs in the context of a living business, your practice, which can sometimes be unpredictable. Each patient is different. There are no formulas, no guarantees...it is a dynamic process.
As you know, the evolution of our discipline(s) is also a dynamic process that involves the rational integration of emerging research with our collective clinical experience and the preferences of our patients. I understand that staying current on scientific developments while maintaining your practice, family commitments and personal life is certainly a challenge. I do it too! That's why it has always been the overaarching goal of RRS to promote 'evidence-informed practice' by providing consistent, concise reviews of important emerging research that can benefit your practice by improving patient care. Staying current is very affordable, and can take only a few minutes a week.