Response to Letter to the Editor by Harrison

Article Outline

• Copyright

In Response:

What a fun direction taken in the response from Harrison, Harrison, and Oakley to the invited commentary “Evidence-Based Care and the Doctor's Duty to Care” (JMPT 2005;28(4):215-6)! Despite the fact that the commentary was directed as a review of the socioeconomic realities of health care delivery in the United States today and neither a review of nor a reflection on the literature of outcome measures (either primary, patient-oriented outcomes that reflect changes in quality of life or intermediate outcomes that may reflect physiological/biomechanical change), the framers of the letter choose to mistakenly extrapolate the context.

The statement “Triano's reliance on pain and disability as the only [emphasis added] ‘evidence’ for clinical outcomes is very short sighted” is simply false and seems more to be a foil for the launch of their discussion on their own issues. Beyond the obvious disregard for the context of the commentary, and the use of the inclusive composition device “etc” for important issues tangential to the point of the commentary, the misrepresentation neither reflects my views of the literature nor of practice.

It is reassuring to know that the good doctors are, however, in concurrence with my thoughts about the inadequacy of the RCT as the sole basis for guiding or evaluating practice. Those outside the profession have been and continue to offer limited perspectives on what is in the literature and what the literature offers while others overstate it. Whether we like it or not, these views are being driven down the throats of providers and patients without any systematic or credible response from the profession. Ignoring that burden altogether or the use of ad hoc/parochial responses have thus far failed our patients and us miserably. That is, in fact, the point of my editorial.