Which EBM you talking about?

K and I went out for drinks last night, and after the fourth drink I started bitching about my job again.

angry doc: Aiya, all this talk about EBM (Evidence-based Medicine) is bollocks lah.

K: No what. We are still practicing EBM what. Just not the same EBM you talking about.

angry doc: Huh? What do you mean. Experience-based Medicine issit? Professor say means must be correct. Or Emotional-based Medicine? Patient want you give.

K: No. Evidence-based Medicine right? What is the evidence based on?

angry doc: Er… trials lah. Clinical trials lah.

K: Ya. So who sponsor the clinical trials?

angry doc: Er… drug companies lor.

K: Ya. So when the drug companies sponsor a trial, they will sponsor one where their medicine is used right? Even when a trial includes an arm on diet or exercise as a means to control the medical condition, there will be an arm with their drug to compare, right?

angry doc: Er… ya lor.

K: So it’s Medicine-based Evidence, right?

angry doc: Ya… but that’s MBE what?

K: Wait. So when the drug company want to choose a drug to use in a trial, which drug, which medicine they choose? Of course the one that will make the most money right?

Why you think they go and make drugs for erectile dysfunction instead of new antibiotics to fight drug-resistant TB? Because poor people who get TB got no money to buy new drugs, and the rich got money to spend on better sex!

Why you think nowadays all the trials basically compare the company's own product against their competitor's product? All fighting for market share only.

angry doc: Huh?

K: So it’s Economics-based Medicine lah! EBM!

angry doc: Economic-based Medicine... Medicine-based Evidence... Evidence-based Medicine…

K: Correct!

angry doc: You full of Ethanol-based Mumbo-jumbo lah…