I think another systemic problem is that medics I know have said 'I have to trust my colleagues'. In the press of work, the way to get the work done is to trust that the colleagues are correct. It leaves the whole health delivery system like a beehive invaded by parasitic wasps or cuckoo bees. The pharma reps evaded the gatekeepers and inserted their beliefs straight into the health delivery system. One thing I would like to see moved forward is a way for medics and other health care professionals to have group study time for continuing professional development, maybe a bit like a research biology lab's weekly meeting. No pharma money allowed, and a lot of practice in reading studies together, thinking about the weaknesses and implications and applications to their practice.