Thinking 'outside of the box' is probably one of the most crucial qualities required by health practitioners. Alas, the world of medicine, and, indeed, the greater world of politics, science, law and most fields, are populated and controlled not by vanguard visionaries, eager to implement new discoveries, but by small 'c' conservative, staid, perhaps even reactionary, or even worse still, self-interested, profit-motivated and status quo-defending individuals and institutions.