To present an example of the advocacy of evidence-based medicine in the hospital setting, namely, the authors' input to the laser Treatment of Benign Prostatic Hyperplasia (BPH) Technology Assessment (TA) project at the Greater Victoria Hospital Society (GVHS). Neither the laser treatment of BPH, nor its proponents, are singled out for criticism. Rather , the TA project is used to examine some of the wider issues relevant to health care reform. Of particular interest are the costs and benefits of integrating an appraisal of effectiveness evidence into a TA project, as this directly challenges the expert opinion of the clinicians involved.