The Issue
Clinicians are commonly thought to hold negative perceptions of clinical practice guidelines—regarding them as overly prescriptive, for example, or driven by cost-cutting concerns. This Commonwealth Fund–supported study is a systematic review of clinicians’ attitudes toward clinical guidelines, based on surveys published in English from 1990 to 2000.
What the Study Found
The researchers found that most clinicians viewed clinical guidelines as helpful sources of advice (weighted mean, 75%), good educational tools (71%), and intended to improve quality (70%). However, some clinicians considered guidelines to be impractical to use with individual patients (30%). Some felt that they reduced physicians’ autonomy and oversimplified medicine (34%), were likely to increase litigation (41%), and were intended to cut costs (53%).
Conclusions
Based on their review, the authors conclude that "contrary to popular belief, negative clinician attitudes are not the major barrier to implementation of [clinical practice guidelines]." Thus, clinician intransigence is not likely to be the main reason that clinical practice guidelines have failed to reduce variations in practice.
