I recently completed some required CME (Continuing Medical Education). I increasingly grew disgusted with the section about guidelines. This is where medical professionals–whoever they are– tell physicians who are practicing in the real world what we should be doing in our everyday practice.

For example, one guideline talked about the appropriate care we should be giving to a patient who reportedly presents with an abscess on his right thigh. The correct answer was to perform an incision and drainage yet NOT to administer a course of antibiotics. Of course, EVERYONE, that’s right, EVERYONE answered incorrectly because EVERYONE in their right mind would have administered an antibiotic.

Nothing works as easily as planned in the real world and since we have to answer to the patient, their family, and their favorite lawyer, we all would have administered the antibiotic–just in case.

It was especially funny because the next senerio they presented was the same patient coming back a few days later with a worsening infection. They asked the question, “Now what do you do? “We said,  “He wouldn’t have come back if we had given him the antibiotics that we wanted to in the first place.”   Who’s making up these guidelines anyway?

Unfortunately, the lawyers read these same guidelines and hold the physicians accountable for any outcome that ends with less than an ideal result.