The literature characterizing prescribing behavior indicates that prescribers learn to employ medicinals by comparing their actions to their peers and teachers. They follow customary rules and cannot adequately assess the outcome of prescribing. We believe that noncustomary prescribers are isolated socially, professionally, and organizationally from other physicians and practice with a greater patient orientation than colleague orientation. Because they receive little or no negative outcome information from patients, they may not modify their actions to fit the newer cautionary customs of the profession stated by a distant leadership. (Author abstract)