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GENERAL PRACTICE: David Armstrong, Hugh Reyburn, and Roger Jones A study of general practitioners' reasons for changing their prescribing behaviour BMJ 1996; 312: 949-952 [Abstract] [Full text]

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"Scientific Skepticism" and "Resistance to Change"

Paul Gorman   (24 April 2001)

"Scientific Skepticism" and "Resistance to Change" 24 April 2001
Paul Gorman, Assistant Professor Division of Medical Informatics and Outcomes Research Send response to journal: Re: "Scientific Skepticism" and "Resistance to Change"	This qualitative study of clinicians' recollections about changes in prescribing practice is a valuable contribution to our understanding of the process. Like much of the writing on this subject, there seems to be an implicit view that change to what is new is to be valued, while adherence to established practices is not. It follows that when clinicians don't change, it must be due to resistance or barriers which must be identified and overcome. There is, however, an alternative point of view, expressed well by Gregory Bateson "It is easy to fall into the notion that if the new is viable, there must be something wrong with the old. ... What is always important is to be sure that the new is not worse than the old. ... Other things being equal, the old, which has been somewhat tested, is more likely to be viable than the new, which has not been tested at all" (1). According to this view, the skepticism expressed by GPs in the current paper is appropriate and consistent with scientific tradition: "From the point of view of rationality, science is above all its method--essentially the critical method of searching for errors (2)." 1. Bateson, Gregory. Mind and Nature: A Necessary Unity. New York: Dutton, 1979. 2. Miller, David. Being an Absolute Skeptic. Science1999; 284 (5420): 1625.