Knowledge Management in Evidence-Based Medical Practice: Does the Patient Matter?

Evidence-based medicine has greatly influenced decisions and actions throughout the health care industry for a couple of decades, particularly in the advanced countries. However, little is known as to how patients with their tacit knowledge have fitted into the evidence-based medical practice equation especially in the developing world, hence the need for this study. The combined use of the theory of communicative action and the AGIL taxonomy of adaptation, goal attainment, integration, and latent pattern maintenance by Talcott Parsons served as the theoretical framework for the study. The theory of communicative action provided the benchmark in understanding how doctors and patients are motivated to adapt and integrate the explicit and tacit knowledge forms in attaining the goal of quality evidence-based medical practice in line with the AGIL taxonomy. The qualitative interviews with fifty respondents - twenty doctors and thirty patients - in the central region of Ghana are utilized as the data base for the discussion. The study concludes that at present patients' tacit knowledge does not matter in the practice of evidence-based medicine in Ghana. This situation has to be addressed by empowering patients to be actively involved in clinical decision-making affecting their health. This is critical because effective implementation of evidence-based medical practice demands a good blend of explicit and tacit knowledge forms possessed by doctors and patients respectively. It is believed that embracing this strategy of managing knowledge in the health care dispensation holds the potential to bring about improved health care outcomes. [ABSTRACT FROM AUTHOR]