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April 5, 2000

Reasons Physicians Do Not Follow Clinical Practice Guidelines

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(13):1685-1686. doi:10.1001/jama.283.13.1685

To the Editor: Dr Cabana and colleagues1 ignore an important barrier to following clinical practice guidelines; most are simply not concise enough. Instead of or perhaps in addition to a 40- or 50-page discussion of all contingencies in the management of a particular disease, why can't there be a 1-page summary saying in effect, "In general, these measures are recognized as essential, these others should be considered, and this group has been found ineffective or contraindicated." Practicing physicians need a checklist to carry in our heads if we are to change our habits. That is what a guideline should be.