Intended for healthcare professionals

Feature Christmas 2017

Know-do-itis and no-do encephalopathy

BMJ 2017; 359 doi: (Published 13 December 2017) Cite this as: BMJ 2017;359:j5749
  1. Linda S Franck, professor
  1. Department of Family Health Care Nursing, University of California, San Francisco, CA 94143, US
  1. linda.franck{at}

Countries around the world invest millions annually to ensure that healthcare is evidence based and that health systems deliver patient care that reflects the most current and rigorous research evidence.

Despite these efforts, there is a surprising and silent epidemic of clinician and health system resistance to the practice of evidence based healthcare. No amount of training, retraining, professional incentives, or governmental regulation seems to overcome this resistance. Moreover, the condition is often contagious, causing intermittent outbreaks of I’m-going-to-do-this-my-way. Recent advances have enabled characterisation of this condition and provided new insights into the mechanisms and possible treatments.


Resistance …

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