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down to practitioners is another question altogether that I have addressed elsewhere. 22 Statistics on the uptake of EBM in general practice are both revealing and shocking. In the 1970s, between 10–20 percent of all health interventions in use in the US were evidence-based, rising to 21 percent in 1990. A more recent British Medical Journal survey showed that in primary health care about "18 percent of decisions were based on 'patient-oriented high-quality evidence.' " 23 The reasons can be summed up as a combination of resistance to change, practical considerations (such as a lack of time), an overreliance on anecdotes and personal clinical experience, and a lack of research literacy. With this situation in biomedical primary care, we might expect things to be even more complex among the MT professions, where the evidence base still lags behind actual practice. This has troubled manual therapists—as well as those in other allied health fields—often leading to intense debates, with some expressing frustration that EBM should trump experience, while tradition and others insist that it must be implemented to the highest possible degree. These debates are not unique to the MT world, and the frustrations of how to apply EBM in real time are an ongoing source of debate in the biomedical professions as well. Greenhalgh 24 is practically a household name among British primary-care clinicians. Her book How to Read a Paper: The Basics of Evidence-Based Medicine and Healthcare, now in its sixth edition, is required reading among medical students and clinicians alike. It is possibly the clearest introduction to the topic any busy clinician could ask for. Writing in 2019, Greenhalgh notes that evidence-based health care has "outlived its honeymoon period" and provides a well- argued explanation of criticisms against EBM—both when practiced badly and when practiced well—with salient recent examples. In the second case, she notes that the meantime, the following resources offer key sources on narrative medicine. For those looking for a place to start, I cannot recommend highly enough Rita Charon's videos: • Rita Charon, MD, PhD. "Honoring the Stories of Illness." TEDx, Atlanta, GA: November 4, 2011. youtu.be/24kHX2HtU3o. • Rita Charon, MD, PhD. "A Sense of Story, or Narrative Medicine for the Chaos of Illness." OHMA Columbia, Columbia University, NY: January 24, 2018. youtu.be/d892f0ynSWc. • Rita Charon, MD, PhD. "The Power of Narrative Medicine." CHCMCCSMTV: June 13, 2017. youtu.be/AYUc1uIHO9A. Also, the University of Delaware Representative Print and Online Resources for Narrative Medicine web page offers research resources (from books to available courses and databases) on humanism as applied to medical practice at sites.udel. edu/jdel/representative-print-and-online- resources-for-narrative-medicine. Another great resource for those interested in integrating narrative medicine with pain science is the Integrative Pain Science Institute. Start with this podcast with physiotherapist Lissanthea Taylor at integrativepainscienceinstitute. com/latest_podcast/pain-and- the-power-of-stories-how-to-use- narrative-medicine-in-pain-care-with- physiotherapist-lissanthea-taylor. Notes 1. William H. Kolb et al., "Editorial: The Evolution of Manual Therapy Education: What Are We Waiting For?" Journal of Manual & Manipulative Therapy 28, no. 1 (January 2020): 1–3, https:// doi.org/10.1080/10669817.2020.1703315. 2. Cameron W. MacDonald, Peter G. Osmotherly, and Darren A. Rivett, "Editorial: COVID-19 Wash Your Hands but Don't Erase Them from Our Profession: Considerations on Manual Therapy Past and Present," Journal of Manual & Manipulative Therapy 28, L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 47 SOMATIC RESE ARCH an almost unachievable formalization and standardization of clinical practice harms the outcome and "de-skills the practitioner," while overreliance (or over-regulation) based on this formalization can lead to "yesterday's best evidence" dragging down "today's guidelines and clinical pathways." Greenhalgh's final point is the most relevant here: "Perhaps the most powerful criticism of EBHC [evidence-based health care] is that if misapplied, it dismisses the patient's own perspective on the illness in favor of an average effect on a population sample or a column of quality-adjusted life-years . . . calculated by a medical statistician." 25 Misapplication can be equally seen in blind adherence to protocol, ignoring patient concerns, but also in relying either on poor evidence or evidence that does not apply to the case in question. It is not enough, in short, to simply "follow the science," nor to overly rely on elements such as a large sample size or higher level of research in a checkbox-style approach. A systematic review or meta-analysis is only as good as the studies it investigates, for example. One must also consider whether the "evidence" applies to the individual case, which may not fall within the narrow parameters of a given RCT. Greenhalgh is in no way an EBM skeptic, and strongly states as much. However, she is able to clarify both the benefits and the valid criticisms of EBM while proposing applicable remedies, noting elsewhere that its failings do "not mean that evidence-based medicine is broken; it simply lacks the needed maturity." 26 It might be worth considering this same phrase for approaches and modalities across the allied health fields. CONCLUSION In the next article, I summarize the principles of narrative medicine in comparison to EBM and the BPS model, and highlight the issues that emerge. In