Julian Tudor Hart has provided us with a much needed call-to-arms to undertake scientific enquiry in our practices,1 although it is likely that the cavalry will need to re-enlist. Once again we need to see ourselves as scientific enquirers working in the unique laboratories of our everyday surgeries to understand the better diseases that affect our patients in the 21st century.
At present, the complex mathematical methods used to design and present results of therapeutic studies have marginalised many clinicians from believing that they can, and have to be, scientific observers. In addition, the so-called hierarchies of evidence commonly used in guidelines, often with randomised controlled trials (RCTs) and their meta-analyses at the top and clinical observations at the bottom, imply that the scientific observations that clinicians can make in their everyday …