 Evidence-based medicine is a tricky concept, since its name misleadingly raises the question of who is practicing medicine that is not based on evidence (Goldenberg 2006). Instead, the dispute is over which evidence is best and how it ought to be used. For instance, physicians will often advise patients on which home treatments to use for minor lower back pain, with individual physicians varying in which treatments they recommend, even aside from differences in the advice based on differing patient characteristics. Ibuprofen? Acetaminophen? Heat and/or cold compresses? Exercise? The standard twentieth-century medical response would be to let physician groups (including consensus groups convened for this purpose) lay out the options and perhaps use their collective expertise to make a recommendation, but giving great leeway to individual physicians to use their individual accumulated expertise to choose another of the available options seen as viable options by their peers. EBM instead treats this as a matter to be largely decided by empirical research. I.e., we ought to run randomized control trial experiments that compare the efficacy of alternative options by randomly assigning patients with lower back pain into Treatment A or Treatment B—controlling for the single variable—and measure the effects on patients using predetermined metrics (change in reported pain severity, incidence of major side effects, etc.). After doing multiple experiments we can then do a “systematic review and meta-analysis” that compiles the data trends across parallel research studies and helps us build an evidence base for creating guidelines for which treatment clinicians ought to use. Those guidelines dictate the proper default practices, which individual clinicians can contravene if specific individual patient needs are in conflict (e.g., a patient history of not responding well to a certain medication).