Some tests and procedures increase treatment cost without improving patient outcomes enough to justify their use. Extensive empirical evidence of how well a treatment works and what it costs does not free health care policy makers from tough value judgments. The question remains whether a given expenditure is justifiable in human terms, bounded by the hard realities of what we can afford. Physicians, even those who supported CPGs in the past, may not support them now that the primary objective is cost reduction, not quality improvement. Payers may use CPGs to deny payment for care that doctors believe should be provided to their patients despite the cost.
Some physicians simply doubt the scientific validity of CPGs.
They tend to weight their own personal experience more than the results of even large data-set studies. CPG proponents seek to answer the objections and gain physician support. Many federal and state health care reform proposals offer various malpractice immunities for physicians who support and follow CPGs. Increased Use of CPG's Raises Important Legal Questions. Traditionally, the law measures doctors' actions by reference to professional custom and practice.