American guidelines on managed care are not the answer

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7062.946b (Published 12 October 1996) Cite this as: BMJ 1996;313:946
  1. Rhian Evans, Research associate
  1. Center for Health Studies, Group Health, Seattle, WA 98101, USA

    EDITOR,—If, in their editorial on clinical guidelines in the independent sector, Gillian Fairfield and Rhys Williams are suggesting that the guidelines used by American managed care organisations to authorise care are evidence based then they are misguided.1 In a national poll Group Health in Seattle was recently acknowledged to be “one of the best [managed care companies] at monitoring health, risk behaviors and disease outcomes.”2 Group Health has clinical guidelines that are strongly based on the effectiveness literature. They total just 13. Some health maintenance …

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