2009-The Physician of the Future English and Catalan

F UNDACIÓN E DUCACIÓN M ÉDICA (FEM) 30 1.2. Evidence-Based Medicine Physicians’ work is inspired by the scienti"c method which consists of gathering evidences/information (signs & symptoms) and applying the principles that explain them in order to reach a diagnosis. Diseases are conceived as biological entities with ethiological treatments that can be classi"ed. Following this trend, doctors’ tasks have become as compartmentalised as the scienti"c-technical advances in diagnosis and therapeutic procedures of diseases, focusing on obtaining “hard” information about patients’ conditions and neglecting the “so%” ones that colours patients’ narratives of their sickness. In doing so, doctors may shy away from therapeutic options suitable to the patient’s context, for example the relational attitude, known also as placebo e'ect. $e scienti"c ideology drives critical and inquisitive minds, with an undoubtedly positive e'ect. Nevertheless, when the popperian “falsability” approach is neglected in favour of dogmatic infallibility it becomes “scienti"sm” that negatively in&uences professional behaviour. Consequently, the physician that attempts to act only within the framework of scienti"c rationality tends to neglect the relational component of his interaction with the patient. Feeling discomfort at tackling decisions in uncertain scenarios, such as those that o%en characterize the physician’s relationships with frightened and distressed patients, more uncertainty and fear may be generated if they do not generate trust, which in turn, produces greater use of health services. In this respect, it is worth mentioning that at least one third of patient complains do not correspond to any of the recognised nosological entities. Nowadays, Evidence-BasedMedicine (EBM), the systematic approach to maximising scienti"c rationality in clinical decision- making, is a well established positive trend as long as the physician practitioner does not neglect his so% skills in the “ars medicarum”. Critical analysis of available evidence in the international scienti"c literature has contributed