Evidence-Based Medicine and the Limits of Standardization

How is medical knowledge produced and what are the implications of that knowledge production for medical practice? Using theoretical ideas on evidence-based medicine, standardization in medical research and practice, and biopower, I examine the relationship between medical knowledge and medical practice through the case of pelvic pain care in the US.

Data from ethnographic observations at two medical conferences as well as interviews with healthcare providers inform a critical analysis of the medical discourse.

The analysis reveals how evidence-based medicine is practiced in the context of medical conditions that lack objective evidence, as well as the unintended consequences of such practices. I provide an alternative approach to medical practice for conditions lacking traditional evidence through presenting outlier cases in the data.

In doing so, I make the broad theoretical argument that biomedical paradigms must emerge through the critical process of negative dialectics in order to reach past the limits of standardized medical care.

In sociologically analyzing the case of pelvic pain care, I reveal dire limits in the evidence-based approach to medical care for conditions and symptoms that may be deemed medical anomalies, demanding an alternative approach to care for such conditions.