Jerold J. Kreisman, MD

Medical training is awash in catch phrases and shibboleths. Some can be useful (“When you hear hoofbeats, think horses not zebras”); others, perhaps overly simplistic (“If it’s not in the chart, it didn’t happen”). A current divination clinging to medical consciousness is the concept of evidence-based medicine (EBM).

Lord, protect me from all the institutions that want to guard me from harm-Congress, PhRMA, academics, journal publishers, and even my APA. They fear I will be brainwashed. They fear-heaven forefend- I may use drugs “off-label.” I hesitate to inform you-it’s too late! I already prescribe medications offlabel, and I do it every day.