We are announcing and introducing a new approach to understanding practice and developing consensus which is grounded in the concept that we are both a global village and need local responses to local problems. We are a group of intensive care and perioperative clinicians and want to start a new movement to improve communication and to give a new voice to many colleagues. Please join us and help us in our journey. Web-based democracy medicine: a new approach to develop clinical recommendations based on systematic review of literature validated by web-global-polling. Guidelines are usually released by a pool of so called experts and opinion leaders but this method tends to be elitist and poorly representative of the community of clinicians who will have to make decisions daily on medical concerns. Web-based democracy medicine allows to take into account the clinician’s opinion through a web-voting process. The use of the Web for the purpose of research and consensus development is in its infancy, and the possibilities are vast. Moreover this new type of evidence has the potential to involve low-income countries and to increase clinician involvement.