Authors’ Reply—We prefer to refer to the approach Dr. Grey advocates as “conservative” rather than “Canadian” prescribing, although we and many Canadian physicians would wholeheartedly endorse his approach.1 Insisting that we physicians be more diligent in doing our “homework” is fine, but it will not be easy to compete with the sort of sophisticated marketing efforts the “estrogen implant” story represents. Sadly some of the homework reading might have entailed reviewing these “experts’” reviews that failed to disclose conflicts or give a balanced picture of the drug’s risks and benefits. Dr. Grey’s practice of working with his patients to educate them to be more cautious with drugs, noting that they are generally receptive to this advice, is an important message for physicians to hear. It directly contradicts views that portray patients in general and women in particular as excessively demanding of medications, positing such demands as the cause of the epidemic of estrogen and other drugs’ overuse.

Gordon D. Schiff, MD, Brigham and Women’s Hospital, Harvard Medical School, 1620 Tremont Street, 3rd Floor, Boston, MA 02120, USA (e-mail: gschiff@partners.org).