11 Theory into practice: within a department

Numerous obstacles stand in the way of evidence-based medicine in obstetrics and gynaecology. These include seduction by clinical authorities, the false idol of technology, the tendency to let sleeping dogmas lie, the pursuit of pedantry in medical education, and the problem of clinical numerators in search of a denominator. Recognizing the importance of placing our practice on a more scientific footing, we launched evidence-based medicine in our department in a municipal academic hospital in 1993. We orient all new clinicians to the process of evidence-based medicine and level the intellectual playing field. As clinical questions arise, we decide them in a group setting using the best available evidence. This has led to a number of changes in practice. Easy access to information around the clock is fundamentally important. Resources include access to literature searches, the Internet, the Cochrane Collaboration on Pregnancy and Childbirth, ACOGNET and Epi Info 6. Evidence-based medicine equips clinicians to practise safely and effectively both now and, what is more important, in the next century.