Evidence-based practice has some limitations when it comes to public health care. The concept has been used in clinical medicine and public health. In addition, the concept is used in policy making, as well as health promotion. The broad interpretation of evidence is often done in policy making and health promotion. Kemm (Kemm, J. 2006) discusses the limitations of evidence based medicine .
When it comes to health, the limitations of EBHC can be closely related to the randomized controlled trials and this occurs when communities instead of individuals are used as the unit of intervention. This means that the randomized controlled trials become inappropriate for public health intervention studies. The evidence based practice when seen as the “best solution” tends to ignore the fact that the decision-making process is complex. When evidence is available, the policy makers are often enlightened when confronting policy problems that are experienced in health matters.
However, it is important to note that, though the evidence enlightens the policy makers, it does not provide direct answers to the existing problems. Borry et al (Borry, P et al. 2006) asserts that the manner in which the evidence-based policy is implemented in public health, can also be applied in clinical medicine. Evidence-based practice or concept is also important in psychiatry. Despite its importance, evidence-based practice only covers a limited range of problems that are encountered by the psychotherapists and psychiatrist.
In psychiatry, there is more complexity as compared to the other branches of medicine. Evidence-based practice due to its conceptual views fails to consider the effects of complexity in psychiatry. The concept fails to put into consideration the effects sufficiently. This makes the concept to have limited usefulness in assisting the clinicians to address certain problems when it comes to fluctuating, as well as symptomatically shifting diseases.
In psychological medicine, the therapeutic and diagnostic procedures are considered as being iterative which then makes it necessary for the decisions to be re-evaluated constantly. It is this clinical reality of psychological medicine that is not clearly reflected by the focus of the evidence-based concept when it comes to decision making. This makes it difficult for the evidence-based concept to assist clinicians to benefit from optimal psychiatric clinical care.