Posted by: Richard Hollis | April 19, 2010

Evidence Informed Care and Chiropractic IV

“Evidence-based practice (EBP) is an approach to health care wherein health professionals use the best evidence possible, i.e. the most appropriate information available, to make clinical decisions for individual patients. EBP values, enhances and builds on clinical expertise, knowledge of disease mechanisms, and pathophysiology.  It involves complex and conscientious decision-making based not only on the available evidence but also on patient characteristics, situations, and preferences.  It recognizes that health care is individualized and ever changing and involves uncertainties and probabilities.  Ultimately EBP is the formalization of the care process that the best clinicians have practiced for generations”.  Source: McKibbon KA (1998). Evidence based practice. Bulletin of the Medical Library Association 86 (3): 396-401

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Responses

  1. Hi Richard,
    There are many sceptics who would love a crack at a man on the BCA council. I think you are making good points. Can I referr to you as an “enlightened” BCA man. (Its only because you started out with me and a bit of my charisma obviously rubbed off on you)

  2. You can refer to me as anything you like, it’s never stopped you before :-)

    I’m happy for to stand up for my opinion on chiropractic. I think many “sceptics” would broadly agree with both the way I practice and the way I believe the profession has to change in the UK. I stood for BCA council last Autumn because I thought it was time to “put up or shut up” and I wanted to influence the future direction of the BCA.

    I will post on Wednesday an article I wrote for “Contact” last year on this.

  3. Hi Richard you are making good points.

    I have just done a posting chiropractic and colic and asked sceptics for their suggesion according to the evidence available, what to advise parents instead of chiropractic there have been no offers. Check out the discussion on this article http://www.guardian.co.uk/science/2010/apr/16/quacks-alternative-medicine-regulation?showallcomments=true#end-of-comments Chiropractors can make a much stronger convincing case for their eficacy around empirical evidence and qualitive studies. Thats what I have always argued for. “Meade 1990″ pointed the BCA in the wrong direction, they have now tried to reinvent themselves three times over the last twenty years. They should go back to basics.

  4. I read your comments in the Guardian. Your proposed mechanism for helping otitis media is an interesting one. Why don’t you write up the 4 out of 5 children as a case series.

    As you know I didn’t fail to get into medical school, but chose to be a chiropractor. I would like chiropractic to be more widely available on the NHS none the less. There are currently 2 PCT’s that have done so in the UK by commissioning practices to see back and neck pain patients. The improved outcomes, decreased cost, better quality of care and patient satisfaction that have been recorded should be applauded.

    There are many people in the UK who cannot see a chiropractor because they cannot afford it. I would like those people to have access, wouldn’t you?


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