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Towards person-centered healthcare via realistic evidence-based medicine – informing the debate historically

Timo Bolt, Frank Huisman


There is a widespread feeling that, despite the many successes of evidence based medicine (EBM), the movement is now facing a serious crisis. The current debate on this ‘crisis’ may be understood as resulting from four interrelated evolutions which EBM went through. Our historical analysis of these evolutions leads us to two conclusions. First, it looks like the spirit of anti-authoritarianism, (self-)criticism, independence of thought and empowerment of individual physicians of the early days has gone. Second, the often-invoked image of the ‘golden past’ of ‘real EBM’ is distorted, as it reflects contemporary nuanced ideas rather than the initial program of the movement. Thus, history teaches us that we should forget about the idealized image of ‘real EBM’ and embrace realistic EBM instead.

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