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RIP EBM

Continuity

Have you got a sec? Could you just sit me down and explain exactly what’s happening?

The tipping point was the Government announcing an HRT tsar. Really. As in, yes, the Government really has announced an HRT tsar and, yes, it really was that which pushed me into incomprehension.

I’m not going to get flushed and sweaty about the menopause furore – been there and done that (read all about it.) It’s just that this latest initiative is another in a long line that suggests the SatNav of medical policy intends to dump doctors in an Ocean of despair. Without a paddle.

We don’t have to think too hard to recall a time when medical practice was largely dictated by things like evidence, science and logic. But it seems that medicine has, at last, caught up with the modern world, where things like experts and facts no longer matter.

So the post-truth version includes fab ideas such as (off the top of my head), opportunistic population AF screening, patient access to all prospective medical notes, pharmacists directly referring patients for two week referrals, open access CT scanners in shopping malls and football grounds, referrals turning into advice and guidance, blanket DOAC switching and, yes, a response to the discovery of this new thing called ‘menopause’ which suggests that, unchecked, it’s going to obliterate half the population.

And all of these are based on what? An approach which is non-evidence based, drum banging, populist, whimsical, short-sighted, non-scientific and/or nonsensical. Because that’s how post-truth works, right? We’ve flipped from an evidence based world to the wild west.

Which makes me wonder why, as a GP, I’m still expected to be constrained by EBM vehicles such as NICE, QOF, prescribing guidance et al – although even if I wasn’t, my own self-respect and professional pride wouldn’t let me practice a form of medicine which might appear popular and progressive but which actually drags us back to the dark ages.

And that’s why I don’t understand what’s going on. Then again, I am seriously lacking in oestrogen, so maybe that’s the problem. How do you book an appointment with a tsar?

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield