Doing the Right Thing (Essay‪)‬

The existence of variations in how medicine is practised is well known to patients, doctors and health administrators. My paper opens with a description of a real clinical event (names have been changed), and then presents evidence of the presence and extent of practice variations for hysterectomy. I outline the difficulties faced by Evidence Based Medicine in supporting best practice. Using the theoretical framework of connectionism, I then introduce and discuss evidence that the hospital medical culture has a significant influence on clinical decision-making. I conclude with a discussion of the broader implications of this research. PRACTICE MAKES PERFECT