A central feature of general practice is the use of time in the management
of patients and their illnesses, The use of active interventions such as in
vestigations or therapies within the context of this dimension has implicat
ions for the development of clinical guidelines for primary care, Important
ly, their recommendations of best practice must be compatible with the comp
lexities of the holistic relationship between GP and patient. Many existing
guidelines adopt a reductionist, algorithmic approach, losing applicabilit
y and relevance to primary care in the process. Here we identify the key fe
atures in the primary care management of the patient with dyspepsia, and ex
amine the utility of existing guidelines for the management of Helicobacter
pylori infection. Through this comparative analysis, the scope and nature
of primary care-centred management guidelines are identified.