Implementing the evidence

For a long time there has been ample evidence that variable standards of practice fail significant numbers of patients. Furthermore, even dramatically positive results from rigorous clinical studies can remain largely unapplied.1 However, we live in a world where there is increasing political and patient pressure to show the effectiveness of what we do as doctors, and standardising clinical practice is becoming everybody's business. We might agree that the practice of medicine is not reducible to a mechanistic, fault free system, however, health professionals owe it to patients to apply the most effective practice.