Retirement of experts or a clarification of their role?
In 1982, Dr David Sackett wrote a paper in which he called for the compulsory retirement of experts in the health sciences (1). He based his recommendation on two types of harm such experts could cause. One is that their observations may be afforded a weight or prestige disproportionate to the scientific evidence. Second, experts may be greatly tempted to accept or reject new evidence, not on the basis of its scientific merit, but rather according to the extent to which it agrees with their prior beliefs or own body of research, thus demonstrating a bias to new ideas. In 2000 Sackett noted that there were '. . . still far more experts around than is healthy for the advancement of science' (2).
Oxman and colleagues, tongue in cheek, developed 'A field guide to experts' (3). Several statements they used to describe experts were 'An expert is a man who has stopped thinking -he knows!'. Or 'An expert is somebody who is more than 50 miles from home, has no responsibility for implementing the advice he gives, and shows slides'. Another was 'An expert is a man who has made all the mistakes which can be made in a very narrow field'.
An expert could start to feel unwanted, ridiculed. Some call for his retirement, others poke fun at his tendency to pomposity. Fortunately, there have been those who have defended the role of the expert, arguing that they have a critical role to play gained through their extensive experience, and hence have much to offer -even in the context of evidence-based medicine (4,5,6).
Readers could be asking themselves, how could this journal, called Evidence-Based Child Health, contain something called an 'Expert Commentary'? Is this an oxymoron? If we re-visit one definition for evidencebased medicine it states 'The practice of evidencebased medicine means integrating individual clinical expertise with the best available external clinical evidence (. . .) By individual clinical expertise we mean the proficiency and judgment that individual