Guitar Hero

Guitar Hero

Sometime an article's title just makes me smile. As an example, I offer Implementation of evidence-based practice: A naturopath perspective.

Given their education and practice, if naturopaths actually applied evidence-based principles they would all be unemployed.

But evidence-based medicine despite its flaws is like  democracy, is worst method of evaluating efficacy except for all those other methids that have been tried.

The authors agree:

Evidence-based practice (EBP), an approach to clinical practice that places emphasis on the use of best available research evidence for decision-making, has been adopted broadly in clinical practice. As a patient-focused approach, EBP promotes the spirit of inquiry. It can also facilitate consistency of care across professional boundaries, and clarify the directions of research.

Ah , but is it the best?

However, over-emphasis on systematic reviews and randomised control trials as the "gold standard" for evidence is a major limitation of EBP as it is being practised today.

"gold standard" in quotes is like "fresh" fish. It suggests that it is neither gold nor a standard. And that is because the practice of naturopathy and CAM fails to meet the standards of science-based medicine. Why? CAM is special.

Complementary and alternative medicine (CAM) therapies often fare unfavourably under the scrutiny of EBP due to the lack of research and inherent differences in healing ideology.

That is because so much of CAM is divorced from reality. It isn't healing ideology, it is the difference between using fact vrs fiction as the basis of practice.

Naturopathy is a unique form of CAM, based on both traditional and scientific knowledge.

Except for the whole based on scientific knowledge part, at least to judge from their websites.

However, naturopaths need to reconcile tensions between traditional and scientific knowledge in their choice of treatment remedies, while adhering to the naturopathic principles of healing, to benefit the patients. They must also maintain their emphasis on clinical expertise, and also patient preferences and values, in clinical decision-making.

See, there is an out to actually applying evidence to practice. You don't really have to do the hard work of applying science and evidence to your practice, just reconcile the tensions. As F. Scott Fitzgerald should have noted, "The test of a second-rate health care provider is the ability to hold two opposed ideas in mind at the same time and still retain the ability to practice naturopathy."

I recently came across an interesting headline: Homeopathy: the air guitar of medicine. I like the metaphor, but it is not quite right.

Guitar Hero. It's Guitar Hero. Naturopathy (and Chiropractic and Acupuncture and all the other pseudo-medicines) is to Guitar Hero what Medicine is to playing a guitar. CAM gives the illusion of being a doctor, like Guitar Hero gives the illusion of being a rock star. But when the time comes to play the solo from Stairway to Heaven in front of a live audience on a 1959 Fender Telecaster, it is not going to work.

Points of Interest 02/10/2016
Points of Interest 02/08/2016

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