Dr. Daniella Zipkin is a Duke University Medical Center assistant professor of medicine who teaches a curriculum centered on evidence-based medicine (EBM), which is medicine grounded in the best quality clinical research. In a 2012 Mount Sinai Journal of Medicine paper considering various aspects of EBM, Dr. Daniella Zipkin pinpointed a number of barriers encountered by physicians in integrating EBM in primary care.
A key challenge to implementation of evidence-based medicine in clinical practice involves physician concerns about maintaining professional autonomy in the doctor-patient relationship. Other issues involve time constraints and general skepticism as to the validity of presented evidence. Focused workshops have proved most effective as part of a multi-layered educational intervention process, with a significant percentage of physicians changing their attitudes as they gain practical EBM knowledge. In addressing time-constraint issues, available data suggest that interventions do not need to be extremely involved or time-intensive to have the desired effect of improving the quality of primary care. More work is ongoing in terms of bringing best evidence to the point of care, especially through electronic health records systems.
A key challenge to implementation of evidence-based medicine in clinical practice involves physician concerns about maintaining professional autonomy in the doctor-patient relationship. Other issues involve time constraints and general skepticism as to the validity of presented evidence. Focused workshops have proved most effective as part of a multi-layered educational intervention process, with a significant percentage of physicians changing their attitudes as they gain practical EBM knowledge. In addressing time-constraint issues, available data suggest that interventions do not need to be extremely involved or time-intensive to have the desired effect of improving the quality of primary care. More work is ongoing in terms of bringing best evidence to the point of care, especially through electronic health records systems.