SUBMISSIVENESS TO HEALTH AUTHORITIES AS AN OBSTACLE TO PRACTICING EVIDENCE BASED MEDICINE
Abstract
OBJECTIVES
The objective of our study was to investigate whether submissiveness to medical authorities could interfere with practicing of evidence-based medicine by family physicians.
METHODS
A qualitative, semi-structured interview on a sample of family physicians in Podgorica, Montenegro, was conducted. The interview schedule was developed through consultations with fellow clinical pharmacists and pharmacologists, and its face and content validity was checked by a pilot study.
RESULTS
The physicians mostly relied on non-evidence based sources of information such as opinion leaders, colleagues, unsystematic experience, pharmaceutical companies and uncritical internet search. Their main goal was to become “encouraged”, “affirmed” and “supported”, which resulted with psychological gain, but did not guarantee benefits for the patient. The most trustworthy information sources were national experts recognized by the heath authorities, well known “professors”, regardless whether they were practicing the evidence-based medicine themselves, or not.
CONCLUSIONS
Although the family physicians have heard of the evidence-based medicine, and they value it as something positive, they do not have sufficient initiative to change routine behaviour and improve their practice. Such attitude has deep roots in hierarchy of power within authoritarian society, and probably will change slowly, together with gradual development of democracy.References
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