Evidence-based methods include computerized literature searching, guidance on how to appraise studies and clinical practice guidelines. But while some practitioners like Dr. Richardson find that evidence-based medicine has transformed the way they practice, other doctors express serious reservations. Evidence-based medicine may be the lingo of the day among clinicians concerned with the quality and cost of health care, but it's far from universally accepted, let alone practiced. Outside of Canada's McMaster University, where evidence-based medicine was pioneered and infuses training from day one, very few medical schools and training programs teach its methods in any systematic way. The tools aren't ready yet.
Most practitioners are just too busy.
Many of them are still computer shy. They need training and support. Resistance to evidence-based medicine is in part fed by computer illiteracy and innumeracy, but experts say that problems also come from the implications for physician autonomy. You still have to figure out how that pertains to your patient's circumstances, and your patient may differ in ways that are important. That takes a little bit of sorting time.