To the Editor.
—I strongly believe that those of us working in academic medicine have a responsibility to identify important areas where health care can possibly be improved. I think Dr Willcox and colleagues1 have done that in their study of prescribing patterns for the elderly. Also, I equally strongly believe that those of us in ivory towers have no business passing judgment on our colleagues in full-time practice without a full understanding of the problems and processes involved in the issue. I am afraid it smacks of elitism to analyze a database, adopt a set of criteria not designed for the population, and then make statements about "poor prescribing patterns," "unnecessarily exposed to potentially hazardous prescribing," and not gather any information on outcomes or even talk to the prescribing physicians. The text repeatedly refers to "possibly inappropriate drug prescribing." The word "possibly" is conspicuously absent from the title.