Response to Miles and Mezzich

Abstract

Miles and Mezzich offer a substantial and focussed account of a “crisis” of knowledge, care, compassion and costs in modern medicine. Their claim is that an over-emphasis on scientific, even scientistic medicine, has resulted in the depersonalisation of care. In response, they propose an emergent model of clinical practice grounded in person-centred medicine (PCM). We are honoured to have been offered an opportunity to respond to this paper. We will not attempt to de-construct the paper or rehearse arguments concerning the limitations of evidence-based medicine (EBM). Rather, we would like to support the general thesis of the paper and offer some form of thought related to how PCM might best develop.  In doing this, we will be very careful not to dismiss the valuable role that science and systematic research play in healthcare. Thus, we have little interest in using EBM as some form of ‘strawman’ by which to pronounce ‘the new way’. Parts of Miles and Mezzich’s paper appear at times to do this. Ultimately, however, we do not see this as the primary intent of their otherwise excellent discussion paper.