You Want a Clinician Who Treats You as Person

"Evidence Based Medicine was formalized in the 1990s, largely by Canadian physician David Sackett. Sackett described the goal of EBM is to replace hunches and habits with data and clinical trials. Clinical guidelines were developed involving protocols that tell doctors which drug to prescribe first, what dose to use, when to escalate treatment, and when to refer a patient to a specialist."

"The studies that generate these guidelines often underrepresent women, older adults, children, people of color, and anyone with more than one diagnosis. The 'average' is a statistical construct. And when you apply a treatment designed for a construct to a human being, you're not practicing medicine—you're practicing statistics."

"Knowing a patient's history, family, stress, and habits predicts outcomes more powerfully than any checklist. The therapeutic alliance is more important than the medication itself in determining treatment success. 15-minute appointments force algorithmic care, leaving patients unseen, unheard, and frustrated."

Evidence-based medicine, formalized in the 1990s, replaced clinical hunches with data-driven protocols and guidelines incorporated into electronic health records. However, this approach treats a statistical average patient that doesn't actually exist. Clinical trials often underrepresent women, older adults, children, and people of color, creating guidelines based on incomplete populations. Individual patient factors—history, family background, stress, and habits—predict treatment outcomes more effectively than checklists. The therapeutic alliance between doctor and patient matters more than medication itself. Time constraints forcing 15-minute appointments enable algorithmic care that leaves patients feeling unseen and unheard, contributing to treatment failures despite identical prescriptions.

Read at Psychology Today