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January 17, 1977

The Physician: The Key to the Clinical Application of Scientific Information

JAMA. 1977;237(3):239-241. doi:10.1001/jama.1977.03270300043003

MY USE of the word "information" instead of "knowledge" is intended to stress that the physician often has to act on evidence that cannot be classified as "scientific knowledge." My remarks will be based on two premises. First, although "the practice of medicine today is clearly a cooperative venture that relies on the expertise of many individuals in addition to that of the physician,"1 when a physician is granted a license to practice medicine, he is charged with the ultimate responsibility for deciding what diagnostic procedures and items of therapy will or will not be provided. Second, this is true and will continue to be true whether the physician is in private practice, institutional practice, or government service.

Ingelfinger2 has succinctly defined the good physician as one who practices by "the exercise of well-based and independent clinical judgment." I interpret this as suggesting that when a physician plans