Medical Practice

Physicians have at their disposal a large number of diagnostic techniques and therapeutic modalities. The challenge is to select the most appropriate and cost-effective approach for the specific patient and that clinical condition. Formal clinical practice guidelines are being developed by government and professional organizations. These guidelines ensure that no patient, regardless of financial status, receives substandard care; protection is provided to the physician against inappropriate malpractice charges; and the insurance company is protected against excessive use of medical resources. There are, however, negative aspects to the use of guidelines. There may be major differences of opinion on the routine use of certain procedures, such as mammography. Guidelines, by being broadly applicable, cannot take into account the genetic and environmental effects on individuals. Therefore, the key is to utilize the guidelines as a meaningful framework while maintaining the flexibility to judge each case in the overall context of the reasonable standards set by knowledgeable clinicians. Under these circumstances, medicine will remain a learned profession rather than a mere technical vocation.

Cost Effectiveness in Medical Care

With the spiraling cost of health care, it is necessary to establish priorities as to how money is allocated. There is a greater emphasis today on the prevention of diseases. There is much that physicians can do to foster cost control but socioeconomic concerns should not interfere with the welfare of the patient.