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Editorials |1 June 1994

Credibility, Cookbook Medicine, and Common Sense: Guidelines and the College

Peter E. Dans, MD, Deputy Editor

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Copyright ©2004 by the American College of Physicians
2004
  • Annals of Internal Medicine, Philadelphia, PA 19106. Requests for Reprints: Peter E. Dans, MD, American College of Physicians, Sixth Street at Race, Philadelphia, PA 19106.
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Guideline [n] −a line by which one is guided: a.) a cord or rope to aid a passer over a difficult point or to permit retracing a course; b.) an indication or outline (as by a government) of policy or conduct [1].
Practice guidelines − systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances [2].
Guidelines and their siblings (protocols and algorithms) are not new [3]. However, their popularity has burgeoned, especially when compared with their more restrictive first cousins (standards, prediction rules, and decision rules) (Table 1). They have been hailed as the salvation from the wide variations in medical care and simultaneously lamented as harbingers of the ruination of medicine as we know it [4]. A friend expressed concern about the potential for lawsuits now that his subspecialty organization is developing guidelines. In Maine, steps have been taken to protect guideline users against liability [5]. One wonders how such a seemingly harmless term became invested with such great and terrible expectations!
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Dans PE. Credibility, Cookbook Medicine, and Common Sense: Guidelines and the College. Ann Intern Med. ;120:966–968. doi: 10.7326/0003-4819-120-11-199406010-00010

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Published: Ann Intern Med. 1994;120(11):966-968.

DOI: 10.7326/0003-4819-120-11-199406010-00010

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