It is imperative that a distinction remain clear between “guidelines” and “standards of care”. The latter are often the basis of malpractice suits and Medical Board actions against physicians. A standard of care is a community-developed construct of what is acceptable in the community in which a patient lives and the doctor practices. It considers individual variation in patient needs, desires, and community resources. It never stipulates that all patients be treated in an exactly specific way. But it establishes a minimum of good care. Guidelines, on the other hand, exist to advise doctors of what is currently known as best scientific practice. They do not consider patient differences and are not designed to be used in actions against doctors. Their level of scientific accuracy is variable, and the lowest standard is those which rely upon “expert opinion” rather than scientific study. Conflicts of interest with the authors of the guidelines might exist. CDC guidelines are designed for public health purposes, and not for use by individual doctors with individual patients.

We are concerned that there is a movement to make guidelines into standards of care and remove doctor and patient choice from the mix.