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To the Editor: Unfortunately, the results of Dr Merenstein's trial¹ demonstrate that juries, as well as some attorneys, misunderstand EBM, believing that its focus is as a cost-saving method of practice. The American Academy of Family Physicians (AAFP) stands behind its use of EBM in the development of clinical practice guidelines, continuing medical education, and quality improvement. We continue to develop, on our own and with other specialty organizations, clinical practice guidelines that are based on critical evaluation of the current best evidence and that incorporate shared decision making.

Some physicians may respond to high-profile cases such as this one by ordering unnecessary tests and procedures in the belief that if they can adhere to all standards—evidence-based or not—they will prevent malpractice suits. Since each diagnostic or treatment intervention carries its own risk, attempts to practice such "defensive medicine" will over time expose patients to unnecessary injury. Instead, we hope . . . [Full Text of this Article]

Michael Fleming, MD
President, American Academy of Family Physicians
Leawood, Kan

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