Abstract

This book examines why physicians are often surprisingly reluctant to follow guidelines for treating patients based on research data, assesses the merits of these concerns, and proposes ways of developing more useful data and more effective guidelines that would reduce their objections.Interviews with doctors at four diverse medical centers revealed that moral concerns drive much of their resistance, and these ethical issues frequently overlap with worries about legal liability, financial incentives, the scientific validity of the data, and the objectivity of the issuer of the guidelines. This volume concludes that in order both to make effective use of scientific studies and to establish a better balance between statistical results and skilled observation in the practice of medicine, physicians need to participate in all phases of outcomes research.