Evidence-based medicine (EBM) was introduced in the early 1990s. In less than 15 years, it has dramatically changed the way that medicine is practiced and taught. Improvements in informatics and evidence resources have helped overcome some of the initial problems and allowed busy clinicians to use EBM in practice. Many barriers to using EBM still remain. Further work on translating evidence into patient care decisions and understanding patients' preferences is required in order to realize the improvements that EBM's early proponents envisioned.