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It has been 20 years since this article has been published. Have the promotion of clinical practice guidelines increased the health of our patients, or have we seen rising numbers of the unfit and unwell?
As more and more "evidence based" physicians deny visits from pharmaceutical company representatives, piously eschewing the tainted lunch, dinner, etc., said companies have directed their (marketing) funding towards disease specific pseudo-charities, who's clinical practice guidelines committees seem stacked with clinicians who to a one, have received funding from not one, but half a dozen companies with interests in the guidelines recommendations. Alternatively, where guidelines are published by governments, the focus seems to be on spending the least amount using the oldest, established, "tried and true" therapies.
As doctors of medicine, rather than "doctors of health" we are only proffered yet another chemical agent, rather than helped to recall physiology, and pathophysiology, to understand where the patient strayed off the path of health in the first place. A good rule of thumb is that if a given recommendation could make someone, or some industry, considerable profits, it is likely false, or at best, sub-optimal.
J. Lance De Foa, B.Sc.H., M.D.
Multi-Skilled Rural General Practitioner
White River Medical ClinicCompeting Interests: None declared.