Integrating practice guidelines with financial incentives

Practice guidelines, in whatever form, hold significant implications for the delivery and the financing of health care. Hence, great care must be taken in developing them. They must be scientifically sound and thus defensible. They must incorporate clinical perspectives and consider patients' preferences. They must cover appropriate as well as inappropriate services. They must foster creation and adoption of a rational payment system. What guidelines, in their best form, can do is enable physicians, faced with an overwhelming array of often conflicting information, to reduce some of the uncertainty they must cope with and to practice the most clinically effective medicine. For physicians to do so requires valid information from a credible source, most often in conjunction with appropriate financial incentives.