ABSTRACT
Few urologists will admit to not having felt some kind of emotional response when the term ‘evidence-based medicine’ was first heard or read. If they are pressed, urologists’ responses are probably little different from those of other doctors. Some see it as just another addition to the long list of fashionable ways of thinking about clinical problems – general practitioner fund-holding, quality assurance programmes, total quality management, clinical audit, and critical care pathways – and, typically, championed by a group of enthusiasts keen to promote their novel approach with something approximating evangelical zeal. A certain, but guarded, intellectual inquisitiveness in evidence-based medicine might be allowed – just enough to defend reasonably a position – but no more. For, in the end, evidence-based medicine might be easily dismissed on the grounds that it states the very obvious, yet another term for describing what we already do. Responsible urologists, by definition, practise in a critical and careful way. They keep up to date, go to scientific meetings, discuss cases with their colleagues and give the best care they can to their patients. The question could be posed, ‘Who are these people that insist on telling us what we should or should not be doing with men presenting with infertility, benign prostatic hyperplasia or early prostate cancer?’1-3 ‘Surely, with our long specialist training and wealth of clinical experience, we must be best placed to decide what is best for our patients.’
