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Making the Improbable Probable: Communication across Models of Medical Practice

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Abstract

Cooperation and conversation in the public sphere may overcome historical and other barriers to rational argumentation. As an alternative to evidence-based medicine (EBM) and patient-centered care (PCC), the recent development of a modern version of person-centered medicine (PCM) signals an opportunity for a conversational pluralogue to replace parallel monologues between EBM and its critics, and the calls to EBM to debate its critics. This article draws upon elements of Habermas’s theory of communicative action in order to suggest the kind of pluralogue that is required for stakeholders in modern medicine to benefit more from publicly conversing with each other than speaking alone or using debate to argue against each other. This reasoned perspective has lessons for all discourse when deep value-based and epistemological differences cannot be easily adjudicated.

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Abbreviations

AAMC:

Association of American Medical Colleges

EBM:

Evidence-based medicine

PCC:

Patient-centered care

PCM:

Person-centered medicine

PCOR:

Patient-Centered Outcomes Research

PCORI:

Patient-Centered Outcomes Research Institute

US:

United States

WHO:

World Health Organization

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  1. Department of General Practice and Primary Health Care, University of Auckland, Auckland Mail Centre, Private Bag 92019, Auckland, 1142, New Zealand

    Stephen Buetow

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“Too long has our beloved Southland been bogged down in a tragic effort to live in monologue instead of dialogue”.

Martin Luther King Jr., Letter from a Birmingham Jail, 16 April 1963.

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Buetow, S. Making the Improbable Probable: Communication across Models of Medical Practice. Health Care Anal 22, 160–173 (2014). https://doi.org/10.1007/s10728-012-0214-3

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