Recently the following appeared in the proceedings of a national scientific meeting:
Every so often scientific medicine needs
And EBM is the current iron fist
That reductionists use in a power play
So that clinical experience has less sway.
EBM enjoys a widespread cult status
With RCTs and meta-analyses its overpowering flatus.
Its ethos demands that statistics advise,
Whereas clinical opinion is a despicable vice!
There is no denying that EBM is a good move
To embed medicine solidly in scientific proof.
Increasingly, however, clinicians are less keen,
For cook-book medicine is not their scene.
And the applicability of RCTs to the complex patient
Sorely tests a practitioner’s patience.
Nor are they happy that those litigation lions
May be plundering their assets with EB guidelines.
But EBM is waning on the scientific stage
As genomic medicine becomes the next new rage.
Yes, EBM is moving into a recession
As society becomes besotted with a new obsession
That effectively dismisses the EBM sage,
For alternative medicine is now centre stage.
(Martin Van Der Weyden, 2003)
Is this caustic cynicism or perceptive prophecy?
Only time will tell.
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