The phrase “evidence-based medicine” is uttered so often in the medical world that it can lose its meaning. So what does it mean? We use the phrase to highlight the ways that medical knowledge and practice are based on scientific data, systematic studies that allow us to determine what really works, to distinguish cause and effect from random associations. And modern medicine has been built around that notion of scientific objectivity.
But I also like to think of the many gaps in that evidence, the known unknowns but also the unknown unknowns. We can only use the evidence we’ve first sought to gather, after all. We can only seek answers to the questions we think – or allow ourselves – to ask.
My next guest, Olivier Drouin, is trying to ask questions that might expand our notion of evidence-based medicine. With his focus on behavioral science, Olivier seeks to better understand the ways we behave and make decisions, the influences that shape and distort our thoughts and actions. As you’ll hear, Olivier sees this as an untapped evidence base, one that scholars in psychology, economics, political science and law are familiar with, but that medicine has tended to ignore.
Olivier Drouin is a pediatrician and health services researcher in the Division of General Pediatrics at Sainte-Justine university health center, a pediatric research hospital in Montreal. He trained as a Research Fellow at Harvard, where he also obtained a Master’s of Public Health. Before that, he completed his clinical training at Sainte-Justine and at the Montreal Children's Hospital, where we were fellow residents. He conducts fundamental and applied research in the fields of behavioral economics, public health, global health, and health policy. He’s often called upon to comment on topics related to child health in local and national media.
Olivier and I first met in pediatric training at the Montreal Children’s Hospital, when he was my chief resident and one of my earliest clinical teachers. We’ve been friends, and occasional collaborators on writing projects, ever since. One thing I’ve always appreciated about Olivier is his commitment to research that has concrete, practical applications, and his broad intellectual range, which allows him to make connections across disciplines.
A NOTE: we use the terms “obesity” and “overweight” in this conversation, because they are typical medical terms. However, I realized after recording that they can be hurtful and stigmatizing. I apologize for that, and I intend to use more inclusive and respectful language from now on, but I did choose to keep the discussion on the tape, as I do believe it’s valuable.
A CORRECTION: I refer to ozempic and related drugs as GLP-1 receptor antagonists. In fact they are GLP-1 receptor agonists.
Daniel Kahneman: "Thinking, Fast and Slow"
Richard H. Thaler and Cass R. Sunstein: "Nudge"
Daniel Kahneman, Olivier Sibony, Cass R. Sunstein: "Noise"
Recorded May 2nd, 2023
Art: Jeff Landman
Music: Mr. Smith