Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
In Reply: Dr Veatch points out that physician
disagreement with the value judgments incorporated within a guideline may
be another reason for physician nonadherence. In our article, we found 33
surveys investigating physician disagreement with guideline-specific recommendations
as a barrier and 15 surveys investigating physician disagreement with the
general concept of guidelines.1 There are
many specific aspects of guidelines that physicians may find objectionable.
Although guideline authors have been urged to state their value judgments
explicitly,2 we found no studies that examined
disagreement with value judgments as a reason for guideline nonadherence,
as Veatch suggests. It is an interesting point that deserves study.
Cabana MD, Rand CS, Powe NR, Wu AW, Abboud PC, Wilson MH. Reasons Physicians Do Not Follow Clinical Practice Guidelines—Reply. JAMA. 2000;283(13):1685-1686. doi:10.1001/jama.283.13.1685