So You Want To Be An Evidence-Based Plastic Surgeon?: A Lifelong Journey

Your initial reactions to the terms “outcomes” in medicine and “evidence-based medicine” (EBM), terms that have increasingly appeared in the medical literature over the last 15 years, may have been similar to ours: fear of the unknown, a sense of indignation that our surgical results would be subjected to undue scrutiny, and perhaps outright hostility. We all think that we are “experts” in what we do! How dare anyone question our results and think they could improve upon our work! We are taking great care of our patients and they are doing fine, so why do we need to consider changing? Furthermore, the term itself sounds cold and too detached for plastic surgery, a specialty that necessarily involves close interpersonal relationships with our patients, each of whom has unique needs and desires that do not seem amenable to a seemingly homogenized statistical review. How could EBM, a seemingly “emotionless” statistical science, help us improve outcomes on a group of people who do not on the surface seem to be subjected to statistics? Another thought was that we do not have time to become statistical experts. Will not EBM take too long to learn and practice? And who was it who wanted to impose this new type of medicine on us, anyway? These and other thoughts made us initially reluctant to consider EBM as something to consider. Over time, however, we began to realize that EBM was not something to be afraid of or to resist. Our resistance began to dissolve once we understood what it truly was and could do, not only for our patients but also for our own capabilities as surgeons. We are convinced that it will help you deliver ever-better surgical care for your patients and will make you determine what are truly the best techniques and …