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June 1995

The Effectiveness InitiativeI. Medical Practice Guidelines

Author Affiliations

From the Department of Ophthalmology, W. K. Kellogg Eye Center (Dr Trobe), and Division of General Medicine (Dr Fendrick), School of Medicine, and Department of Health Services Management and Policy, School of Public Health (Dr Fendrick), University of Michigan, Ann Arbor.

Arch Ophthalmol. 1995;113(6):715-717. doi:10.1001/archopht.1995.01100060039027

We examined the impact of the "effectiveness initiative" and medical practice guidelines on the practice of ophthalmology. The effectiveness initiative asserts that much of current medical practice is unnecessary or harmful, too costly, and unresponsive to patient desires. It promotes more critical review of the medical literature, research on outcomes, and stringent practice guidelines. Whereas current practice guidelines are helpful in codifying accepted procedures, they tend to sanction interventions of unproved value. Future guidelines will probably reject unproved interventions, especially if they are expensive. Although such guidelines may limit physicians' freedom of choice, they may protect them against capricious malpractice claims and unreasonable patient expectations.

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