"There is concern that guidelines intended to reduce variation and improve the quality of care have instead resulted in medicine becoming authoritarian
and bureaucratic.2 Evidence generated from large populations
has been distilled into large numbers of lengthy and technically
complex guidelines. Guidelines in turn have been used to create
financial incentive schemes such as the UK’s Quality and
Outcomes Framework, whereby a substantial proportion of
general practice income depends on achieving thresholds for
drug therapy or surrogate outcomes in accordance with National
Institute for Health and Care Excellence guidelines. Not only
do these thresholds exceed the limits of the evidence for many
people but they also encourage clinicians to ignore the need to
elicit and respect the preferences and goals of patients".

-un saludo juan gérvas @JuanGrvas