# RKS: KNOWLEDGE-BASED vs EVIDENCE-BASED DECIDING & DECISIONS

The Never-Ending Tug-O-War!

1st October 2021

THE FIGHT BETWEEN THE CONSERVATIONIST vs LIBERALS!

Dear Reader,

In every sphere of life and living there are two profiles of individuals and this determines a person's individualism. The take-forward of the same implications pertain not only to the future of the Company, or the country or even the individual's career, it also foretells the physical and mental health outlook.

THE CORPORATE PERSPECTIVE 

In sales and marketing there are two types of mind-set leaders. Either the Company opts for a Captain who intends the organization to prosper by paying attention to cutting corners, or zooms in on a visionary whose mission is to shift gears by organic growth and diversification. 

The easiest path to show growth and profit is to cut costs. It is but evident and a no-brainier. Any ordinary subservient individual with similar position has enough experience of this mechanism of profiteering. It is only those who are knowledgeable have the visionary capability to drive a conceptualized mission.

The mind-games juggling within the brain of the recruiter is a determiner whether it will be a the boon or the doomsday for the Corporate (eventually)! 

THE COUNTRY PERSPECTIVE

Similar to a corporate, a country needs a visionary to carve a new path of glory and not trudge upon a trodden path. Those seeking fame normally endeavor attaining the same by cooking someone's goose. It is only those who are knowledgeable who spell their objectives before-hand and put-into action what is preached or broadcasted. 

I remember a junior colleague of mine, a bubbly and eager-to-scale greater heights, albeit quickly, who once told me that he announces in advance to his friends of his next designation he will get on promotion and the time frame within which he will definitely achieve (not just merely desire to aspire)!! He explained further that this puts pressure on him to attain the already pronounced goal always and, believe me, this could never have been attained if he chalked his career path on basis of evidence; his knowledge provided him with wisdom and the latter paved his progress to achieving greater career heights.

THE HOLISTIC PERSPECTIVE

Why do millions of commoners flock to hear a preaching? The self-professed God man gives discourses based on knowledge. Those who listen in rapt attention are ordinary evidence-based believers. That is why many of these who even confront the 'Sadhus' with challenging questions, albeit unwittingly and unsuccessfully. Those with brittle minds succumb to the words of wisdom, and that is after discounting the corrupt and fake ones in the tribe.

What drives an individual to graduate from an ordinary citizen of a locality or a country to a global religious Guru is his knowledge-driven discourses. No one's experiences can ever be all-encompassing - they can only substantiate or add flavor to knowledge. 

THE MEDICAL PERSPECTIVE

The word evidence-based is the pet of academic Medical Professionals or those practitioners with a strong academic bent of mind! They can never see beyond evidence because reasoning is by-far an alien art for them. The patient chooses his fate depending upon his choice of the health - provider - he / she thereby unknowingly falls prey to even a set mind. 

The COVID-19 is a stark eye-opener for the evidence-based believers and professors in medicine. One anti-cold product with additional zinc got the chopping block because no  'apparent' robust evidence of any zinc benefits against the virus. Come year 2019 & the pandemic invasion, the world over zinc is the flavor of decade, or even could be for the century, for its anti-viral and immune boosting actions and the very same regulators started singing praises for this mineral to fight the COVID-19 - causing SARS-CoV-2 virus! Why??? The evidence-based medicine has its flaws. It never can be the ultimate gospel truth.

In a similar enlightening situation the cardiac surgeons seem to be prevailing upon interventional cardiologists with respect to choice of options in those with opening up of choked arteries of heart. When more than 3 significant coronary heart blocks require re-channelizing of blood, the evidence-based dictate is to opt for bypass surgery and to  overlook the stenting option. I have never understood this logic. Both bypass as well as coronary stenting attain the same objective of achieving re-vascularization. But bypass entails a 6-8 hours long open heart surgery with a 3-month off-routine diversion, and a permanent chest scar reminding for the rest of his / her life that one is an heart patient and boy - you now forever better be on your toes. The stenting, if it is technically feasible, will be accomplished within minutes with maybe 1-2-day of hospital stay and resumption of office and other normal activities within very few days! Have got quite a handful of my patients undergo more than 2-3 stents stenting and even one of them having inserted 9 stents! it is now history that very same patients have been hale-n-hearty for over a decade with no signs of complications, including rejections. The stent manufacturers must surely have factored the foreign body rejection angle, and the regulators would definitely have ensured stent safety and success before permitting the same in usage for human intervention. The success or failure of the stenting, and even the bypass, for that matter, actually depends on the skill of the interventional cardiologists or the cardiac surgeons - the BOTH procedures themselves being well-designed and having a history of being in vogue for decades. Just think if the stents fail because of the perceived threat by a foreign metal insertion then nobody should undergo a knee transplant because there a whole chunk of metal put in the body here!!

 

TAKE HOME MESSAGE

The consumers are becoming faster enlightened than the patients. The answer is simple - illness or sickness overwhelms them and they succumb to trusted influencers who incidentally profess in sync with one's mindset. Therein lies the danger. Doctors who strictly follow protocols are blinded believers of evidence-based medicine. They have possibly no enough understanding presumably to take an otherwise call. I would say the supplements and nutraceuticals are bereft of hardcore evidences of their benefits and all those who do not advocate the same automatically classify themselves as stern practitioners of evidence-based medicine. The thinking beyond escapes their list of options. The nutraceuticals are great for their multifarious benefits and there is more than enough written, and documented, benefits based on their usage over generations, and explored and discovered mechanisms responsible for their health welfare. So is the case with traditional Ayurveda products. These heal provided one believes well-enough to advocate and use the same.

Be a liberal in life. Not a conservationist! The same will spell success for an individual and build a strong organization as well as nation, and translate into a personal healthier living - all by opening horizons.

DR R K SANGHAVI

Prophesied Enabler

Experience & Expertise: Clinician & Healthcare Industry Adviser