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“Often the study of the study of how therapies should work is much more extensive and comes before the study of whether therapies do work,” the authors write. Thus a medical culture based on “should work” rather than “does work” is condemned to constantly correct itself when the science is finally evaluated for outcomes that matter. To fix this constant backtracking would require nothing less than a revolution in how doctors are trained, with an emphasis on the proven and practical rather than the theoretical. (It would also require a second revolution in how doctors practice, with less prestige and remuneration for coming up with new ideas and more for validating old ones.) - www.nytimes.com