The use of practice guidelines in Wisconsin for liability protection

It seems many physicians and other health care professionals are reluctant to advocate that the use of clinical guidelines be expanded because of negative experiences with managed care entities that have based their practice guidelines on economic considerations. Those experiences have led to the erroneous belief by some that all guidelines are minimal or substandard. The trend is clear, however, that clinical practice guidelines will be increasingly important not only in courts but also in the management of health care. They are here to stay and they provide the medical profession with an opportunity now more than ever to decide its own destiny in medical malpractice litigation without the need for new legislation in Wisconsin. Accordingly, physicians should become pro-active at medical staff departmental meetings, in local and national professional associations, and, if necessary, in the political arena to encourage the adoption of valid guidelines--those that meet acceptable medical standards. In this way the risk that practice guideline use will become both the maximum and minimum standard of care will remain only a theory. While the decision to use clinical practice guidelines is solely up to a physician, he or she should be aware of a guideline's recommendations for any given patient situation. Ideal practice can still be followed by bad outcomes that prompt patients to claim negligence. By choosing a valid guideline and making a reasonable attempt to follow that guideline, a physician has maximized his or her opportunity for both preventing and prevailing in litigation. If, however, a guideline exists and it is unintentionally ignored, liability is more likely.(ABSTRACT TRUNCATED AT 250 WORDS)