I'd like to believe that practitioners are aware of the results of clinical trials, read articles comparing interventions, and make decisions reflecting their assessment of these findings. The sad truth is I rarely find evidence to support this belief. Ask 100 psychiatrists if a single antipsychotic medication is superior to all others in its efficacy in the treatment of schizophrenia, and they will all know the answer. “It’s clozapine.” Ask 100 clinic directors how many patients in their services are treated with clozapine and how many should be, and the apologies and explanations begin. Ask colleagues if they read any psychopharmacology trials. Although many know the literature, the N=1 study (“I tried my patient on that medication and he did really, really well, so that’s what I use”) seems far too common.