Evidence-Based Medicine

I thought The Gold Standard’s discussion of the role of evidence-based medicine in doctoring to be one worthy of further investigation. One well-written article found online said, “Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.” It later reads: “evidence based medicine is not “cookbook” medicine. Because it requires a bottom up approach that integrates the best external evidence with individual clinical expertise and patient’s choice, it cannot result in slavish, cookbook approaches to individual patient care.” I suppose I’m bothered by the fact that EBM is something that people feel needs to be implemented; given the nature of medicine, it seems, to me at least, logical to use the “current best evidence” in making decisions. Perhaps I’m unclear as to what the alternative is...pulling a diagnosis out of a hat...? I wouldn’t be one to assume that EMB yields “cookbook” medicine because, though individuality in patient care is important, evidence and statistics can provide valuable information. It seems to me that it would be awfully difficult to practice medicine without some sort of evidentiary backing. Then again, I’m not a doctor, so I really don’t know.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2349778/pdf/bmj00524-0009.pdf