PHYSICIANS VIEW OF PRACTICE GUIDELINES - A SURVEY OF ITALIAN PHYSICIANS

After more than 10 years of development, two different views of practi ce guidelines are emerging: either as an educational tool for the medi cal profession, or as a forum where health care issues can be debated by physicians and non-medical groups. Physicians use practice guidelin es in the former model to set their own standards of good quality care , while the latter approach needs contributions from other components in order to decide what should be provided by our health care systems. In a survey of Italian physicians' opinions and attitudes toward prac tice guidelines, responders supported the ''narrowest'' model. More th an 80% stated that improvement of quality of care and reduction of var iation in clinical practice styles should be the aim of practice guide lines, without representatives from outside the medical profession bei ng involved (61%, 79% and 86% disagreed with a possible involvement, r espectively, of patients, health care administrators and representativ es of the public at large). Overall, 38% of physicians had a positive attitude toward guidelines viewed as a quality assurance tool for the medical profession. Overall, physicians seem to ignore that the need t o rationalize health care calls for input from other professions and m embers of society. Indeed, most of the issues facing medicine today ar e mainly a matter of how much value our societies attach to the benefi t expected from the available health services. The answers as to what should be done in health care probably cannot be left to the medical p rofession alone. Copyright (C) 1996 Elsevier Science Ltd