[Problems with the implementation of medical guidelines]

Neither today nor tomorrow will medicine be completely encompassed within guidelines. Those who have been concerned with developing guidelines in the past years are well aware of the limitations involved. At present, the most important task is to review the flood of current guidelines to check their compliance with the criteria quoted here, as has already been done for English guidelines in the internet. In the future, too, other "paths of knowledge" besides guidelines will continue to be taken to improve the quality of medical care in Germany. Quality management as a whole offers many as yet unused possibilities for making such improvements. Academic research and the teaching of quality management would give a new impetus to the spreading of guidelines, and achieve greater acceptance. These points are necessary, if we are to produce the evidence for the efficacy of quality management.