311 W7. Discussion Post

W7. Discussion Post

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Clinical decisions need to be evidence-based as far as possible. Evidence-based practice is the use of scientifically generated evidence that is combined with the implicit knowledge of the proficient practitioner. Practitioners are using the best available research results while making different decisions. However, Isaacs & Fitzgerald (2001) have proposed Seven Alternatives’ to EBP that can be used by practitioners when they have no evidence on which to base a clinical decision. This paper will discuss the ‘Seven Alternatives’ to EBP that can be used by a health care provider while making different decisions.

There can be the use of Eminence-Based Medicine which is the use of experience in decisions. The experience has more worth than any amount of evidence. Alternatively, practitioners can make use of Vehemence -Based Medicine, which is the substitution of volume for evidence. Elegance and verbal eloquence are also influential alternatives for evidence and can be used under Eloquence-Based Medicine ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"p0aTVqqD","properties":{"formattedCitation":"(Isaacs & Fitzgerald, 2001)","plainCitation":"(Isaacs & Fitzgerald, 2001)","noteIndex":0},"citationItems":[{"id":2396,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/TTITE2N4"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/TTITE2N4"],"itemData":{"id":2396,"type":"article-journal","title":"Seven alternatives to evidence-based medicine","container-title":"The oncologist","page":"390-391","volume":"6","issue":"4","author":[{"family":"Isaacs","given":"David"},{"family":"Fitzgerald","given":"Dominic"}],"issued":{"date-parts":[["2001"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Isaacs & Fitzgerald, 2001). Practitioners can also leave the decision in the hands of the Almighty and make use of Providence-based Medicine. Moreover, the other alternative can be diffidence-Based Medicine in which a doctor must do something in order to look for the answer. Similarly, fear of litigation can be incorporated into treatment that will let practitioners towards over investigation and overtreatment. The last alternative is Confidence-Based Medicine, which can only be used by surgeons.

A health care provider who is implementing one of the “Seven Alternatives’ to EBP also makes the best decisions despite having any scientific evidence as to the basis of their decision. For example, Dr. Keating who practices internal medicine and has introduced a character, “Dr. Reinfrank” in his article. Dr. Ralph used to have "morning report" instead of using scientific evidence ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"rrkAmP42","properties":{"formattedCitation":"(Keating, 2003)","plainCitation":"(Keating, 2003)","noteIndex":0},"citationItems":[{"id":2397,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/4Q8IK5FF"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/4Q8IK5FF"],"itemData":{"id":2397,"type":"article-journal","title":"PLAYING IN THE MAJORS","author":[{"family":"Keating","given":"Herbert J."}],"issued":{"date-parts":[["2003"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Keating, 2003). During the report, he used to hear patients' clinical stories from the night before. Then he provides his instructive feedback in a Socratic style. It was a very successful method of instructing students who were going to be professional. These kinds of characters are preferable when one is lacking with scientific evidence.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Isaacs, D., & Fitzgerald, D. (2001). Seven alternatives to evidence-based medicine. The Oncologist, 6(4), 390–391.

Keating, H. J. (2003). PLAYING IN THE MAJORS. Retrieved from https://www.courant.com/news/connecticut/hc-xpm-2003-07-13-0307130177-story.html