This article is based on a keynote presentation at the 13th Nordic Congress in General Practice in Helsinki, Finland in September 2003. The aim was to demonstrate the strengths and limitations of evidence-based medicine (EBM) in a primary healthcare setting, and to show how and why it also can represent a hindrance to optimal medical care. The presentation comprised two separate lectures. Initially, Marjukka Mنkelن pointed to strengths to underline the need for EBM in general practice. Subsequently, Irene Hetlevik argued that the concept of EBM, on the contrary, could be a hindrance for good