The Users' Guides to the Medical Literature is really a discussion of the use of evidence-based medicine by the McMaster University clinical epidemiology group, their former students, and their colleagues. I can think of no other term that seems to engender more distress among clinicians than the term evidence-based medicine. In conferences, perfectly sane, compulsive neurotically, rigorous basic scientists, become enraged when asked to describe the "evidence" behind their clinical decisions. Expert clinicians seem unable to understand why it is no longer acceptable to just state that a therapeutic decision is correct because it is what they do and their forefathers did. In fact, even bright, articulate dermatology residents seem to think that it is perfectly acceptable to make therapeutic decisions merely because a friendly attending told them to and feign ignorance of evidence-based approaches.