The difficulty in adopting guidelines is the large volume of material that must be assimilated into an individual's practice style. Working with guidelines, however, is nothing new to physicians. We constantly work with a set of protocols that we learned in medical school and in residency training. In our practices, we have modified these protocols with new information and through personal experience. Guidelines can be used as an educational tool to keep us current regarding the myriad problems we face on a daily basis, and on treatments that have changed dramatically since I was a resident.
Guidelines can help shield practitioners from clinical error and malpractice risk.
The most recent guideline I have received is for the early management of acute myocardial infarction. The guideline starts with the initial phone advice for the patient, then progresses through the hospital and immediate posthospital decision sequences. No step is cast in stone and alternative suggestions are included in the pathway. The art of patient education, relieving anxiety, and discussion of the future lifestyle and medical care need to be delivered with a physician's own bedside manner. I use a different guideline for mild brain injury that would probably be accepted by an equal number physicians.