The document discusses criticisms of Evidence Based Medicine (EBM) and defenses of incorporating clinical expertise and experience. It notes that some feel EBM leaves no room for clinical judgment and is now a "problem". However, others argue that expert clinicians possess experiential knowledge similar in kind, but richer than individual clinicians. This expert experience can complement EBM by considering evidence in the context of individual patients.

1. Is EBM broken?
“Today EBM is a loaded gun at clinicians’ heads.
‘You better do as the evidence says,’ it hisses,
leaving no room for discretion or judgment.
EBM is now the problem…” - Dr. Des Spence
BMJ 2014;348:g22
“The expert’s experiential knowledge is not fundamentally
different in kind compared with that possessed by the
individual clinician...
[it is] a richer and more complete version.” - Dr. Mark Tonelli
Tonelli MR. In defense of expert opinion. Acad Med 1999;74:1187-1192.1191:1
expert experience complements
Evidence Based Medicine
The Value of Experience Survey results available at themedicalroundtable.com