Precepts and instruction are useful so far as they go

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Justine Cadet, News Editor

…but, without the discipline of real life, they remain of the nature of theory only.” The sentiments of the 19th century Scottish author Samuel Smiles reinforce the important distinction that guidelines and measures set forth by healthcare regulators and associations only maintain significance when properly implemented into clinical practice.

Last week, Senator Max Baucus put forward a “Call to Action” plan, which detailed provisions that he believes would increase U.S. healthcare coverage, reform the physician payment methodology and scrutinize self-referral practices. While the senator’s suggestions garnered support from organizations like the AHA, they will remain simple proposals, unless embraced by President-elect Obama, his newly appointed Health and Human Services Secretary Tom Daschle and the incoming Congress.

The ACC and AHA have issued new clinical performance measures to help physicians and hospitals in treating MI patients by providing tools for gauging how closely they're sticking to guideline recommendations and where they need to improve. Through performance measures, the associations are trying to reinforce the importance of adhering to guidelines in the daily hospital setting.

Meanwhile, the ACC, AHA and American College of Gastroenterology (ACG) have jointly said that there is no definitive evidence that the use of proton pump inhibitors will restrict clopidogrel’s impact in preventing cardiac events; concurrently, dismissing studies presented at AHA’s scientific sessions, which found evidence to the contrary, as too small to properly address the safety concerns. Therefore, the associations encouraged physicians to maintain current recommendations for medication regimen in this patient population.

European societies are equally interested in seeing protocols turned into clinical practice. In fact, new EU guidelines issued on heart attack management emphasize the importance in speed of action for reperfusion therapy to restore blood flow to the heart and improve survival rates.

However, as Smiles suggests, these protocols and guidelines will remain irrelevant and intangible until they are performed regularly in the practical setting.

On these topics, or any others, please feel free to contact me.

Justine Cadet, News Editor