Family-centered care and evidence-based medicine in conflict: lessons for pediatricians.

In fact, the 2 paradigms approach medical practice from radically divergent perspectives. Family-centered care rests on a biopsychosocial model of healing, is fundamentally holistic, and prioritizes the perspectives of patients and families in medical care, whereas EBM is, at its essence, the systematic application of science to practice. For most providers, EBM connotes provision of the highest-quality care based on the available medical science and is intended to minimize unwarranted variation in care that might result in patients receiving therapies that are unsafe, ineffective, costly, or untimely, compared with the gold standards of care derived from scientifi c evidence and ideally randomized controlled trials, in which “bigger” often means “better.” EBM has gradually supplanted experience-based medicine of decades past, wherein the “experience” is that of the physician. In both evidenceand experience-based systems, the provider is still at the center of the medical encounter.