There are, broadly speaking, two kinds of knowledge—analytic
and intuitive, explicit and tacit. Analytic knowledge is arrived at by
logical deductive thinking, and is a sequential thought process in
which each step can be explained and defended. Intuitive knowledge, in
contrast, is frequently alogical or nonrational (though not illogical
or irrational), and often involves nonconscious mental processes.
Though intuitive ways of knowing are essential to both scientific
research and scientific medicine, the culture of medicine celebrates
only the analytic, evidentiary kind of knowledge, while eschewing
intuition as being “nonscientific.” The popularity and
prevalence of what is known as evidence-based medicine reflects this
bias in favor of the analytic and the explicit. Though the
evidence-based approach has contributed greatly to standardizing
medical care, favoring treatments for which there is evidence of
effectiveness, it has limitations. An overreliance on evidence-based
medicine is problematic, because this approach leaves out important
factors in the actual practice of clinical medicine such as diagnosis
(pattern recognition, hunches), nonverbal cures provided by patients,
and the way the doctor–patient relationship bears on patient
management and compliance, and because it is not appropriate for
dealing with medical conditions that do not lend themselves to study by
controlled clinical trials.