Practice parameters benefit all. Patient management strategies improve outcomes for patients, lower costs for payers

Practice parameters, patient management strategies designed to help physicians make clinical decisions, can eliminate thousands of unwarranted medical procedures each year, resulting in greater satisfaction for patients and lower costs for payers. But physicians have yet to adopt many recently issued parameters. The enthusiasm with which they embrace newer guidelines depends on their views concerning the expertise of the sponsoring organization and the participants in the group that developed the parameter. Practice parameter development is costly. Before creating a practice parameter, it is a good idea to find out if a parameter already exists that can be modified for local use, or if one is being developed elsewhere. Some think inertia is a major obstacle to carrying out practice parameter guidelines. Others believe healthcare professionals' opposition is a more substantial roadblock. Some physicians believe practice parameters threaten their autonomy and the art of their practice. Pressure from patients to use certain procedures can also be an obstacle. Practice parameters work best if developed by authoritative physician specialty organizations. Implementation needs to be backed up with continuing education and feedback.