The BMA http://web.bma.org.uk/homepage.nsf have as the
headline puts it warn(ed) against government bodies undermining
clinicians' decisions.
In a close debate, representatives voted that, in light of the
establishment of the National Institute for Clinical Excellence and
the Commission for Health Improvement, the BMA must ensure
that pronouncements from these and similar bodies do not
jeopardise and erode best treatment of individual patients and/or
undermine the clinical freedom of registered medical
practitioners.
Best treatment of the individual and clinical freedom are concepts
which seem central to the Is it worth it debate?
As a consumer I obviously want my G.P. to consider my individual
needs, however, I do retain a healthy scepticism with regard to
clinical freedom in the light of papers such as that by Neil C
Campbell et al (1998) which demonstrated in a baseline survey of
provision of Secondary prevention in coronary heart disease: in
general practice
that:
" half of patients with coronary heart disease in general
practice had at least two missed opportunities for effective medical
interventions Nearly two thirds of patients with coronary heart
disease in general practice had two or more high risk lifestyle
factors that would benefit from change"
Clinical freedom will be subsumed by guidelines and protocols if
examples similar to this one conitnue to occur.
Ref. BMJ 1998;316:1430-1434 ( 9 May )
Secondary prevention in coronary heart
disease: baseline survey of provision in general
practice
Neil C Campbell, Joan Thain, H George Deans, Lewis D Ritchie,
Mackenzie , John M Rawles.
John Platt
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