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From autonomy to accountability: the role of clinical practice guidelines in professional power.
Perspect Biol Med. 2005 Autumn; 48(4):490-501.PB

Abstract

Evidence-based medicine (EBM) aims to address the persistent problem of clinical practice variation with the help of various tools, including standardized practice guidelines. Based on a systematic evaluation of the available scientific evidence, these guidelines offer recommendations for clinicians about details of patient care and clinical decision making. Because clinical practice guidelines specify how health care should be performed, they could be considered a threat to clinical and professional autonomy. Inspired by the theory of countervailing powers, this article explores how clinical practice guidelines have shifted the focus of professional power from autonomy to accountability. Professional organizations develop clinical practice guidelines as a service to their members but do not require strict adherence to the guidelines. Indeed, implementation studies show at best a modest change in clinical behavior. Such non-adherence might render a profession vulnerable, however, when third parties seize upon guidelines and offer financial incentives to keep clinicians accountable for delivering optimal patient care.

Authors+Show Affiliations

Department of Sociology, University of California-Los Angeles 90095-1551, USA. stefan@soc.ucla.edu

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16227662

Citation

Timmermans, Stefan. "From Autonomy to Accountability: the Role of Clinical Practice Guidelines in Professional Power." Perspectives in Biology and Medicine, vol. 48, no. 4, 2005, pp. 490-501.
Timmermans S. From autonomy to accountability: the role of clinical practice guidelines in professional power. Perspect Biol Med. 2005;48(4):490-501.
Timmermans, S. (2005). From autonomy to accountability: the role of clinical practice guidelines in professional power. Perspectives in Biology and Medicine, 48(4), 490-501.
Timmermans S. From Autonomy to Accountability: the Role of Clinical Practice Guidelines in Professional Power. Perspect Biol Med. 2005;48(4):490-501. PubMed PMID: 16227662.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - From autonomy to accountability: the role of clinical practice guidelines in professional power. A1 - Timmermans,Stefan, PY - 2005/10/18/pubmed PY - 2006/1/19/medline PY - 2005/10/18/entrez SP - 490 EP - 501 JF - Perspectives in biology and medicine JO - Perspect. Biol. Med. VL - 48 IS - 4 N2 - Evidence-based medicine (EBM) aims to address the persistent problem of clinical practice variation with the help of various tools, including standardized practice guidelines. Based on a systematic evaluation of the available scientific evidence, these guidelines offer recommendations for clinicians about details of patient care and clinical decision making. Because clinical practice guidelines specify how health care should be performed, they could be considered a threat to clinical and professional autonomy. Inspired by the theory of countervailing powers, this article explores how clinical practice guidelines have shifted the focus of professional power from autonomy to accountability. Professional organizations develop clinical practice guidelines as a service to their members but do not require strict adherence to the guidelines. Indeed, implementation studies show at best a modest change in clinical behavior. Such non-adherence might render a profession vulnerable, however, when third parties seize upon guidelines and offer financial incentives to keep clinicians accountable for delivering optimal patient care. SN - 0031-5982 UR - https://www.unboundmedicine.com/medline/citation/16227662/From_autonomy_to_accountability:_the_role_of_clinical_practice_guidelines_in_professional_power_ L2 - http://muse.jhu.edu/cgi-bin/resolve_openurl.cgi?issn=0031-5982&volume=48&issue=4&spage=490&aulast=Timmermans DB - PRIME DP - Unbound Medicine ER -