Abstract
Evidence-based medicine (EBM) emerged relatively recently to describe the explicit process of applying research evidence to medical practice. The movement was high profile, yet not overly successful: many clinicians do not use up-to-date evidence in their everyday work. This article shows how a social movement perspective can be used to analyse the emergence of EBM and shed light on power struggles between segments of the medical profession. It draws on Blumer's (1951) essay on social movements to demonstrate the continued salience of this approach. The article also presents empirical data from a qualitative study of English and American surgeons to illustrate how EBM provides a focus for segmental conflict within medical practice between `art' and `science', `practice' and `evidence'. Together these data and the social movements perspective provide insight into the dynamics of this struggle and help to explain why clinicians continue to resist EBM.

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