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Thank you, Sachin, for your suggestion. What we are willing to know are the 'real world' barriers to perform Evidence-based Practice, which may include the ones you raised. Changing cultures may not be easy, probably requiring political actions. This is why we are writing a proposal to the Ministry of Health, Labour, and Welfare grant with this research project in advance. Hideki * * * * * * * * * * * * * * * * * * * * * Hideki Nomura, M.D., Ph.D. * * Deputy Director/Associate Professor * * Department of General Medicine * * Kanazawa University Hospital * * Kanazawa 920-8641, JAPAN * * * * * * * * * * * * * * * * * * * * *