“Evidence-Based Medicine”

“Evidence-Based Medicine” March 12, 2010

As many readers will already be aware, my wife and I experience some difficulty in our practice of Natural Family Planning.  Because of our erratic charts, our NFP instructor recently recommended that we ask my wife’s doctor to do some tests on her vitamin D, iron, prolactin and testosterone levels.

Now, our family doctor is not supportive of our choice to use NFP.  She asks what we use for birth control and, when we say NFP, she writes “none” in our files.  She quietly, but obviously, shakes her head at our superstition and irresponsibility.  When my wife asked her for the tests our teacher had requested, the doctor seemed quite put off.  It was as though we were wasting the system’s valuable resources chasing a phantasm.  We were informed that, though the doctor would grant us the tests this one time, we should understand that this is not normal practice.  We should not expect to be able to get such tests on request in the future.  In her own words, our doctor prefers to do “evidence-based medicine.”

But, however reluctantly, the tests did get done.  We heard back from the clinic in quite a timely fashion.  My wife’s testosterone and prolactin levels were fine.  Her iron and vitamin D, on the other hand, were seriously low.  She needed to be on supplements – and soon!

Our doctor felt that my wife’s vitamin D and iron levels were cause for sufficient alarm.  But how would she have ever known about these problems if the requested tests had never been carried out?  Nothing in her own practice gave her any “evidence” of my wife’s condition.

On the other hand, a woman, whose only medical training comes through a faith-based community group interested in fidelity to the Catholic Church’s teaching on birth control, was able to look at a series of NFP charts and hypothesize that something was off.  Tests confirmed that hypothesis.

I’m not sure what our family doctor considers evidence, but my understanding of the scientific method is that our erratic charts constituted evidence of a potential (and, as it turns out, actual) vitamin and mineral deficiency.  We wonder if, in the future, this experience will make our doctor a little less suspicious of our method of family planning.  If she really is interested evidence-based medicine, the fact that an NFP volunteer caught a serious medical condition that she herself had overlooked should at least give her pause.

Brett Salkeld is a doctoral student in theology at Regis College in Toronto.  He is a father of two (so far) and husband of one.  He is the co-author of How Far Can We Go?  A Catholic Guide to Sex and Dating.


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