Outside the guidelines, no salvation! Really?
نویسنده
چکیده
Can a family physician practise good medicine without following clinical practice guidelines? Obviously, you have the right to come back with, “What do you mean by good medicine?” Let’s define it for our present purposes as that promoted by the 4 principles of family medicine: a family physician is a skilled clinician, family medicine is a community-based discipline, a family physician is a resource to a defined practice population, and the patient-doctor relationship is central to family medicine.1 These principles can be augmented by up-to-date interdisciplinary competencies. The question could seem trivial, even ridiculous, so widely are guidelines distributed and generally used. But it merits being posed as Drs David Gass and Ross Upshur have done in the debate on pages 518-519. Dr Gass suggests that a family physician is hard pressed to practise good medicine without them. In his argument, he reminds us of the phenomenal increase in knowledge in medicine and the difficulty, perhaps the impossibility, of any one person being able to review and evaluate all the published research, basing his argument on the fact that the recommendations are rigorous and credible. Dr Upshur, on the other hand, argues that the guidelines do not cover all the fields of the practice of family medicine, that the empirical data evaluating the use of guidelines are not convincing, and finally, that even the definition of good guidelines raises numerous conceptual problems.
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ورودعنوان ژورنال:
- Canadian family physician Medecin de famille canadien
دوره 56 6 شماره
صفحات -
تاریخ انتشار 2010