Simplicity and Complexity in Medicine

In this report, I will try to show that Evidence-Based Medicine (EBM), in its ambition to propose guidelines, has a simplifying character that contrasts with the complex thought of patients and physicians; that this contrast leads to two events reflecting a crisis in medicine: patients non-adherence and doctors clinical inertia; that if there is a crisis, we must consider the need for a paradigm shift in medicine. This new paradigm would be a person-centred medicine that takes into account the complexity of patient and physician thought; it results in the development of a new type, non-algorithmic, of guidelines and it has profound implications for the teaching and practice of medicine.