There are many ways of combining three letters out of an alphabet of 26; yet still there are overlaps which can confuse meaning. So the first duty of anyone using an acronym is to say what it denotes. Here, POM is “problem-oriented medicine”, EBM is “evidence-based medicine”, and CPD is “continuous professional development”. These designations, familiar as they are to clinicians, define what is meant by these terms, but fall well short of describing them for the general reader, something which must now be done.

Problem-oriented medicine, described and advocated by Lawrence Weed,¹ is an approach which elicits and categorises the patient's problems, both those described by him or her and those discovered on physical examination or in the course of investigation. The list of problems, with the action proposed for each, forms the basis of the clinical record. This approach has the great merit of focusing on what is actually troubling the patient, and it includes the important task of listening to what he says. All approaches to difficult matters have their limitations; those of POM include the inarticulacy of some patients, the impatience of some doctors, the accumulation of problems as age advances, and the inelasticity of time.

Evidence-based medicine has …