Running Commentary

I was talking to my hot-shot high-powered Manhattan editor friend a few weeks back, when I remarked that I couldn't predict which of my posts would garner comments. She interpreted this to mean I should stick to writing, and leave the editorial decisions to people like her.

Well, I don't think even she could've predicted this. Mostly because she edits children's books, but still.

That thread has it all -- passionate positions, good arguments, hidden identities, and blockbuster revelations. Mix in some classic citations from the literature, and you've got a thread that will not be topped, unless my attending jumps into the fray. Or the ankle patient.

I don't think there's much more that needs to be remarked on, since Rose and Anonymous have explained their perspectives well, and came to some understanding. Input from Doc Shazam, Doc Lassiter, and JB was welcome as well.

If you're interested in the finer distinctions of evidence-based medicine, check out these posts from the early days of blogborygmi: Evidence for EBM, Circumstantial Evidence, and Handling the Truth. Kevin, M.D. has also posted on this subject, and wrote originally about the patient who demanded ovarian cancer testing.

Maybe EBM evokes such responses because it pits physicians' best ideals (trust, research to help patients) with their worst frustrations (costs, fears of reprisal). And this duel plays out every day, behind every patient encounter.