About 250 years ago, French philosopher Francois-Marie
Arouet Voltaire, wrote:
“Doctors prescribe medicine of which they know little,
to cure diseases of which they know less,
in human beings, of which they know nothing”.
Has this state of affairs changed very much since then? I
believe so. However, many would argue “hardly”, aside from new
technological advances and certain heroic surgical procedures.
Our model continues to be population-based (also known as
“mass medicalization”) rather than patient-centric. Further,
notwithstanding the current dogma on “evidence-based” medicine,
meaning that the health care provided is based on solid scientific
evidence of utility, a large proportion of tests and prescriptions
used frequently have little or no such supportive evidence.