Getting Doctors to Listen: Ethics and Outcomes Data in Context

By Philip J. Boyle | Go to book overview

JUDITH WILSON ROSS


Practice Guidelines:
Texts in Search of Authority

Introduction

Practice guidelines are both a well-established medical practice and a new phenomenon. Although general rules about how to proceed when practicing the art of medicine have a long history, the rigorous formulation of such guidelines is something new. One hope for guidelines, in the face of extensive practice variations observed twenty years ago by Wennberg, was that medical practice could be made more rational and scientific. A more scientific medicine would also produce a more professional medicine. Patients could be more confident that similar illnesses would be diagnosed and treated similarly, regardless of where they received their treatment. Guidelines have also been seen as a way of reducing health care costs because reliance on these more scientific guidelines would eliminate what was thought to be extensive inappropriate treatment provision.

All three of these hopes may prove unfounded. Research data are often inadequate or nonexistent, and thus cannot be used to create a scientific medical practice. Even among those treatments and conditions that have been well studied, research methodologies are flawed or inconsistent; randomized clinical trials—the gold standard—are hard to find. Thus, uncertainty remains. The hope that a more rational medicine would bolster professional values has also been problematic, as physicians have been reluctant to listen to others' views in the face of a history that treated them as individual entrepreneurs and (near) final arbiters of what treatment should be provided to patients. Last, the hope that guidelines would reduce costs by eliminating inappropriate treatment has had to be reconsidered. The practice variations literature has not led to the expected conclusion that variations result from overuse. Indeed, the source of variation remains somewhat mysterious. 1 It is clear, however, that implementation of guidelines might result in increased treatment and associated costs because it would remedy extensive underuse of some treatment, in addition to overuse.

-41-

Notes for this page

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this book

This book has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this book

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this page

Cited page

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited page

Bookmark this page
Getting Doctors to Listen: Ethics and Outcomes Data in Context
Table of contents

Table of contents

Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this book

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
/ 234

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.