Managed care and medical practice guidelines: The thorny problem of attaining physician compliance

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Abstract
Medical practice guidelines are increasingly being used by managed care plans to ensure quality of care while achieving cost reductions. However, it is unclear that physicians are complying with these clinical protocols. This paper reviews pertinent literature to assist in: understanding why physicians encounter different incentives for complying with guidelines; identifying initiatives that managed care plans can utilize in managing clinical guidelines; and, identifying a research agenda for investigating issues surrounding physician compliance with guidelines.