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Even 'evidence based' clinicians uphold the importance of clinical expertise and judgement. Clinical method is an interpretive act which draws on narrative skills to integrate the overlapping stories told by patients, clinicians, and test results. The art of selecting the most appropriate medical maxim for a particularly clinical decision is acquired largely through the accumulation of 'case expertise' (the stories or 'illness scripts' of patients and clinical anecdotes). The dissonance we experience when trying to apply research findings to the clinical encounter often occurs when we abandon the narrative-interpretive paradigm and try to get by on 'evidence' alone.

Type

Journal article

Journal

British Medical Journal

Publication Date

30/01/1999

Volume

318

Pages

323 - 325