procedures are performed in this country. These inconsistencies are believed to reflect underutilization or overutilization of resources in certain areas, and support the contention that clinical guidelines might reduce practice variation by guiding physicians who are uncertain about the indications for specific procedures and the legal implications of their decisions. These factors helped stimulate the federal government to fund initiatives aimed at reducing unnecessary practice pattern variation."
Self-defense is one explanation for the move to develop practice guidelines. "If the physician is not trusted to know what is best, nor to always choose ethically even if he or she does know, then the social and economic system will step in with alternatives that constrain the physician's ability to define quality of care. The past resistance to such constraints as 'cookbook medicine' have been replaced in some quarters with eloquent appeals to fellow physicians to help create practice guidelines as a means of preserving the autonomy of th
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