Views & Reviews From the Frontline

NICE needs reform

BMJ 2011; 343 doi: (Published 07 December 2011) Cite this as: BMJ 2011;343:d7945
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

Change is difficult for professionals—no one wants to have to unlearn all the certainties they spent years ramming into their memory. But David Sackett changed medicine. He came from the streets and rapped on its corners about evidence based medicine. He swept away the conventions of medical classicism. But like all controversial ideas, in time it became the orthodoxy. Profit is a great motivator and medical corporations quickly adapted to the new order.

Now evidence based medicine is today’s conservatism. Representatives clasp research sponsored by drug companies and steelily say, “You can’t go …

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