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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
1. Bateson, Gregory. Mind and Nature: A Necessary Unity. New
York: Dutton, 1979.
2. Miller, David. Being an Absolute Skeptic. Science1999; 284
No competing interests
24 April 2001
Division of Medical Informatics and Outcomes Research