Authors: Lois Jackson¹; Wayne Putnam²; Peter Twohig³; Frederick Burge²; Kelly Nicol²; Jafna Cox⁴

Source: Health, Risk & Society, Volume 6, Number 3, September 2004 , pp. 239-255(17)

Publisher: Routledge, part of the Taylor & Francis Group

Abstract:

The management of patients through the use of evidence-based medicine has become the 'mantra' of medicine within many Western countries. Evidence-based medicine is aimed at providing the best objective, scientific care to all patients, and reducing as far as possible patients' risks of disease and complications from disease. Based on family physicians' discussions of the use of evidence-based recommendations for two cardiac diseases, this paper explores how subjectively-based trust enters into family physicians' decision to use evidence-based medicine. In addition, we show how trust influences physicians' work of recommending evidence-based medicine to patients, and physicians' perceptions of why patients follow recommendations aimed at risk reduction. We conclude that although much of the current discussion about evidence-based medicine assumes a 'rational' model of physician behaviour based on the application of the 'best objective scientific' results, subjectively-based perceptions of trust influence physician practices, and point to the need to understand the power of relational issues in influencing physician practices even when utilizing evidence-based knowledge.

Keywords: risk reduction; evidence-based medicine; trust

Document Type: Research article

DOI: http://dx.doi.org/10.1080/1369857042000275650

Affiliations: 1: School of Health and Human Performance Dalhousie University Canada 2: Department of Family Medicine Dalhousie University Canada 3: Gorsebrook Research Institute Saint Mary's University Canada 4: Departments of Medicine (Division of Cardiology) and Community Health and Epidemiology Dalhousie University Canada

Publication date: 2004-09-01

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