It seems to me that our natural human inclinations are too often less noble than we aspire too. Being “faith, hope, and love” motivated would be ideal, but I all too often find that even knowing that I should be motivated by posivites it is the negative that acutally does the trick.

The classic (hypothetical) Mac user’s comment: “Well, my new OS upgrade crashes every time I hit the tab key… which has made me realize how it’s so much simpler and cleaner to use the space button for formatting. Brilliant design choice, Apple!”

In the end, though, I (as a clinician) am acutely aware that we are discussing subtleties when the vast majority of daily clinical actions are taken on the basis of virtually no evidence whatsoever. Either the doc is not aware of the evidence, or the research simply hasn’t been done. The possibility (probability?) that population drift undermines the believability of what evidence we have - well, my mind shuts down and refuses to contemplate the implications seriously.

Should we spend research dollars trying to pursue new hypotheses, or continuously retest the ones we’ve done before?

Come to think of it, this might be an argument for the trend of drug comparison trials rather than placebo trials; at least that way we have ongoing evaluation of old therapies as we test new ones.

http://www.math.union.edu/~dpvc/jsMath/welcome.html