Protecting generalism: moving on from evidence-based medicine?

Area of Science:

• Healthcare decision-making
• Primary care research
• Medical philosophy

Background:

• Modern healthcare quality relies on evidence-based medicine (EBM).
• Concerns exist that EBM is insufficient for generalist primary care.
• This insufficiency may threaten the future of primary care.

Purpose of the Study:

• To extend the understanding of quality knowledge use in decision-making.
• To protect and develop the discipline of generalist primary care.
• To propose an alternative framework for primary care.

Main Methods:

• Literature review and conceptual analysis.
• Exploration of interpretive medicine as an alternative framework.
• Identification of priorities for clinical practice and research.

Main Results:

• Evidence-based medicine's limitations in generalist primary care identified.
• Interpretive medicine presented as a viable alternative framework.
• Key priorities for practice and research outlined.

Conclusions:

• A broader account of knowledge use is needed for primary care quality.
• Interpretive medicine offers a promising framework for generalist care.
• Further research and clinical adaptation are necessary to integrate this approach.