ABSTRACT
This chapter explores how evidence-based medicine (EBM) can best be supported in general practice with general practitioners (GP) and what Primary Care Groups/Trusts can do to achieve this support as part of their new responsibilities for clinical governance. The concept of EBM as developed at McMaster University in Canada is a method of developing the lifelong learning skills and problem-solving habits of medical students. Locally and nationally, many GPs have demonstrated some initial reluctance to identifying with clinical effectiveness evidence and the need to practice EBM. Meta-analysis and systematic reviews suggest that the most effective activities to promote EBM in general practice are patient-related interventions, outreach visits, reminders, the use of opinion leaders and multifaceted activities. The idea of nurse practitioners taking more responsibility for the management of certain conditions as a way of reducing GP workloads was raised by a small number of GPs, who indicated that this was something with which their practice was experimenting.
