[Practice guidelines to physicians and their economic aspects; merits and drawbacks].
In drawing up policy recommendations to physicians, two crucial problems arise: to what extent can research findings be extrapolated to everyday practice? And: may or must economic arguments be considered in drawing up the policy recommendation? In the revised consensus 'Cholesterol', the proposals on secondary prevention are based on justifiable extrapolation of available data, but this is not true of those on primary prevention. Use of economic arguments in a policy recommendation to physicians is not acceptable, because it gives rise to a situation in which the treating physician constantly has to weigh economic interests against the patient's interests, so that the patient may begin to doubt if the physician is constantly any exclusively acting as the representative of his or her interests.
Stehouwer
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Academisch Ziekenhuis Vrije Universiteit, afd. Algemene Inwendige Geneeskunde, Amsterdam.
D003327:Coronary Disease / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D004358:Drug Therapy / Q000191:economics*; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy*; D008297:Male; D009426:Netherlands; D010817:Physician-Patient Relations; D011050:Policy Making; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000191:economics*; D011322:Primary Prevention / Q000191:economics*