there are countless studies of varying quality on numberous subjects, but the patient in front of me is unique. i have to offer advice to this person, who for the most part, will follow it. but how do i know that this drug, or this data range are meaningful, and healthy for this patient. in the short run there is less confusion, physiology adjusts with the medications most often. but in the long run who really knows, i don't. there is no way to find the probability that this person in front of me fits into a given study. i can guesstimate a probability, but, BUT it's just a hunch, educated true, but a guess. or is it a hypothesis, is this my own, our own science experiment, on you the patient, where we allow greater latitude where the probability of seriously negative outcome is lower. i guess it is.
i wonder if the clinics that have the highest probability of following evidence based medicine have the longest patient retention, or if they are university, or residency based centers with high turnover. i wonder if being able to adhere to guidelines makes you feel more comfortable, it does me.
the doctor patient relationship can't have changed much over the centuries in-spite of our current technology. being with this other person, with certain expectations, and assigned roles in place. how did we prognosticate on the seemingly healthy person in days gone by, or did we. not much has changed with regards to indulgences of the flesh; too much and we increase the probability of negative health consequences.
