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All of the following statements regarding practice guidelines set forth by governing agencies and professional organizations are true EXCEPT: 

A. Clinical practice guidelines protect caregivers against inappropriate charges of malpractice, yet do not provide protection for patients from receiving substandard care. 

B. Practice guidelines have largely reached a stage of nuance allowing them to address every unique illness and patient presented to the modern physician. 

C. Practice guidelines provide a legal constraint to physicians, and deviation from guideline-based care invariably leaves physicians vulnerable to legal action. 

D. Where different organizations disagree regarding practice guidelines, a third-party agency has been appointed to mitigate these disagreements such that now all major organizations’ guidelines are consistent. 

E. All of the above statements are not true. 


I-1. The answer is E. (Harrison's 19e Chap.1) Practice guidelines have been developed by many professional organizations and agencies as a decision-making aid to caregivers. Most organizations attempt to incorporate the most recent available evidence and concerns of cost-effectiveness into their guideline formulations. Despite increasing levels of nuance in current guidelines, they cannot be expected to account for the uniqueness of each individual and his or her illness. Furthermore, many discrepancies exist in guidelines from major organizations. By setting a standard of reasonable care in most cases, clinical guidelines provide protection to both clinicians (from inappropriate charges of malpractice) and to patients, particularly those with inadequate healthcare resources. Even though guidelines do provide this protection, they do not provide a rigid legal constraint for the conscientious physician. The physician’s challenge is to incorporate the useful recommendations provided by the experts in guidelines and incorporate them into the care of each individual patient. 

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