We have been concerned about the role that guidelines could play in overwhelming patients. This leads to practitioners considering guidelines as mandates for quality, often overriding patient context and patient values and preferences. In the case of diabetes, there is a big concern that many guidelines reflect the interests of for profit interests on professional organizations that formulate these guidelines.
Last year, the VA, led by Pogach, Aron, McConnell and others, produced guidelines that take a different approach – a patient-centered one! To learn more about these guidelines, there is a very interesting discussion in this podcast.
In this podcast, Mark McConnell from the VA in LaCrosse, WI discusses with the Therapeutics Education Collaboration hosts about the evidence in support of diabetes control and how this should be translated in care that fits the life of patients with diabetes. A valiant effort indeed to reduce the way this care can disrupt people’s lives!
Minimally Disruptive Medicine 
Thanks!
Does anyone have any evidence that fear of lawsuits is a major reason why we doctors may feel compelled to follow guidelines rather than patient choice when the two differ?
Mark
Difficult to know – post hoc explanations usually cant be trusted. Perhaps more helpful would be to determine how many lawsuits have resulted from failure to follow guidelines among clinicians who communicate adequately with patients and involve them in shared decision making.