Is evidence-based medicine the real Trojan horse?

I enjoyed reading your thoughtful analysis of lifestyle medicine¹ but worry that it is evidence-based medicine (EBM) itself that is the ‘Trojan horse’ that has smuggled in numerous harmful, unnecessary pharmaceutical interventions. Applying the same crude methodology to ‘lifestyle medicine’ misses the common sense that the majority of these interventions are not only extremely likely to help, whether evidenced or not, but also likely not to cause harm. Relying on validation from EBM before applying our objective common sense is precisely what has eroded the trust of our patients and opened us up to justifiable claims of professional arrogance in dismissing alternative approaches to health care. Nobody is arguing that these are not more effective when applied at a population health level, but this should not preclude GPs from applying our professional common sense in tailoring sensible and safe lifestyle interventions for our patients.

• © British Journal of General Practice 2021