Although the scientific literature is vastly increasing our knowledge about pain, there is concern that clinical application of these findings lags far behind the findings. Evidence-based practice has been put forth as a means for remedying this by basing clinical decisions on the latest “best evidence.” To judge best evidence, meta-analysis of randomized controlled trials is emphasized. By concentrating efforts on meta-analysis, a gap is created between the ideal of randomized controlled trials and the evidence an individual clinician may produce; however, the application of evidenced-based practice may confuse the production of knowledge with issues of quality enhancement and how health care professionals' behavior is altered. Transfer of knowledge is apparently assumed to occur automatically. Taken together, this may take the “reason” out of practice by asking clinicians to rely on externally produced best evidence and to change practice routines accordingly. The clinician may become hard pressed to provide evidence to meet the demands of evidence-based practice, quality enhancement, and productivity. Putting reason back into the process would involve basing practice changes on experience as well as developing research transfer activities that would facilitate communication between those producing the evidence and those applying it. This might entail new ways of conducting research, a greater emphasis on transfer, skills training in practical settings, and the incorporation of better methods of program evaluation. By incorporating single-subject designs, feedback, and a systems approach, clinicians might be better situated to empirically evaluate their results. Likewise, by combining this with broader objectives, for example, quality and productivity and methods for evaluation, the Intentions of evidence-based practice might be better served. As much vigor needs to be put into developing systems for research transfer, skills training, and program evaluation as has been put into meta-analysis.