I have recently been inundated with comments about an article that I wrote. It was published by a major magazine concerning the applicability of various Preferred Practice Guidelines concerning professional licensure and disciplinary actions. While it might make a practitioner feel better to moan over the guidelines sustaining “cook book” medicine, reality must be faced. Various paradigms of practice are accepted by various hospitals, insurance companies and Workman’s Compensation. Violate them and face consequences. I agree that “guidelines” are not hard and fast rules. However, generally accepted guidelines may not be followed for good reason. I implore you, if you decide not to follow them on an individual patient, your chart should state why you are not following the guideline in this instance. Additionally, if you feel that a guideline that is “generally accepted” or in wide use, is not accurate or useful, do something to change it. Write letters to the organization that promulgated it or joint that organization’s guideline committee, if possible.



Lawrence F. Kobak, Esq.