Paper short abstract:

The paper highlights the conflict between evidence-based medicine, data-driven medicine and practice-based medicine (held by GPs) developed in Italy during the Covid-19 outbreak. Multiple meanings of ‘empirical evidence’ and the downgrading of GPs’ practical knowledge and experience are analyzed.

Paper long abstract:

Since February 2020, strategies aimed at containing and managing the Covid-19 outbreak have been developed by European countries. Among these measures, the possibility of an early treatment of the disease has been considered of fundamental importance, both for curing the disease and governing the outbreak. Despite their potential, early (practice-based) therapies were neglected in Italy and the debate around them gave rise to a strong conflict between their proponents and opponents, to the point that some of the former (mainly General Practitioners) organized a properly political movement in order to promote the integration of early home therapies in the official health protocols.

Unlike, many scientists and doctors argued the necessity of waiting for the outcome of the randomized (evidence-based) studies; which, however, arrived after several months. Meanwhile, medicine has moved mostly on the basis of the quantitative data available, sometimes collected with different and not very transparent criteria.

Hence, a harsh conflict developed between several GPs (supporters of the practice-based approach) and scientists and doctors accustomed to following evidence-based approaches and forced to rely on data-driven approaches.

The paper highlights this epistemological conflict among these 3 different visions of medicine and science, the hierarchy of scientific knowledge and professional skills, the downgrading of GPs’ practical knowledge and experience, the multiple meanings of the concept of ‘empirical evidence’.

Particularly, health protocols will be considered as socio-technical objects embedded in a vast range of cultural, political and economic factors that contributed to the general resistance towards practice-based therapies into national guidelines.