The Pharmaceutical Journal
Vol 269 No 7206 pp53-57
13 July 2002

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Letters to the Editor

Evidence-based medicine

Life is not always so simple

From Mr O. Supyk, MRPharmS

While chatting recently with a general practitioner friend the subject of evidence-based medicine came up. We agreed that evidence-based medicine was an excellent guide to treatment but that experience and a "gut feeling" about illness was what differentiated us from newly qualified practitioners. (We have both been qualified for about 20 years.)

Many subliminal messages are picked up from our patients and these often guide us to make, we hope, a correct decision on treatment. Evidence-based prescribing is often the result of meta-analyses of many clinical trials, thereby finding the best treatment for the population. However, people are individual and vary in their response to drugs.

As someone who aims to have a holistic approach to responding to symptoms, I sometimes employ herbal or homoeopathic therapy. The evidence base for this approach is currently small. However, patients often come to me who reject conventional medicine for whatever reason and seek advice about the best possible alternative. I have a lot of success and many patients return. Others learn about homoeopathy themselves and then self-treat. This self-empowerment provides a good feeling for the patient and that in itself can have a positive effect on therapy.

Evidence-based practice is hugely beneficial and I would always offer the drug of first choice, when appropriate. However, life is not that simple. We must not forget the patients at the far ends of the Gaussian distribution.

Orest Supyk
Hinckley, Leicestershire

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