Becoming a Phronimos: Evidence-Based Medicine, Clinical Decision Making, and the Role of Practical Wisdom in Primary Care

J Am Board Fam Med. 2023 Aug 9;36(4):531-536. doi: 10.3122/jabfm.2023.230034R1.

Abstract

There has been much discussion about the overmedicalization of human experience and the problems incurred by overzealous action-oriented medical care. In this paper we describe the Aristotelean virtue of phronesis, or practical wisdom, and discuss how it can be developed by interested clinicians. We argue that becoming a phronimos requires conscious attention to one's practice by using feedback to continually improve. But there must also be judicious adherence to clinical practice guidelines and advocacy for people-as-patients at individual, community, and national levels.

Keywords: Clinical Competence; Clinical Decision-Making; Evidence-Based Medicine; Judgment; Knowledge Translation; Physician’s Role; Standards; Uncertainty.

MeSH terms

  • Clinical Decision-Making*
  • Decision Making
  • Evidence-Based Medicine*
  • Humans
  • Primary Health Care