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EVIDENCE-BASED medicine (Sackett and others 2000) and veterinary medicine (Cockcroft and Holmes 2003) have been emphasised in recent years as essential to both the maintenance and advancement of high standards of clinical practice. In particular, the evidence-based approach must be distinguished from ‘eminence-based’, or even ‘celebrity-based’ (Ernst and Pittler 2006) medicine, where individual practitioners uncritically adopt the practices of articulate and well-known colleagues because of the reputation of the individual rather than the underlying scientific basis of a treatment being promoted (Wood 1999, Greenhalgh 2001). Critics of the modern evidence-based medicine school have been quick to point out the difficulties in its application to every case in busy clinical practice (Ghali and others 1999). Much is undertaken based on received professional wisdom that begins to be adopted from the earliest years of clinical education. This apparent inconsistency has recently been highlighted by a final-year medical student: ‘throughout studies for our medical degrees, we are taught that evidence-based medicine is the way forward … yet, within the medical profession, there are many techniques and conventions that have been handed down from teacher to student, the origins of which have been lost, and there is also little evidence base for them’ (Jones 2008).
For many years, I have been intrigued by the predominance of the left flank approach for ovariohysterectomy in the female cat in the UK (eg, Hickman and others 1995) in contrast to the predominance of the ventral midline approach (eg, Gourley and Gregory 1992) in other parts of …
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