In a perfect world, ACOG’s evidence-based practice guidelines would be issued and physicians would instantly start to incorporate them into practice, allowing patients to quickly begin reaping the benefits of the newest, most relevant research. In reality, changes in practice don’t happen overnight and it can take a while until new recommendations are widely adopted. A recent study on oophorectomy, or ovary removal, at the time of hysterectomy suggests that physicians haven’t caught up with ACOG’s current practice guidance. Previous studies have found the same to be true for other recommendations such as breast cancer screening, bed rest during pregnancy, HPV vaccination, and Pap screenings.
A major component of improving the care we provide our patients is using the latest scientific research findings and medical advances in daily practice. Ob-gyns on the front line of research and patient-care serve on the ACOG committees that develop our practice guidelines. When necessary, committees call on the assistance of additional subject area experts to enrich the recommendations and ensure that the most recent and relevant data are included. The result: solid, evidence-based clinical guidelines. However, the widespread adoption of new guidance can be challenging.
Besides those who disagree with what we’re recommending, there are also people who aren’t aware of new guidance or who prefer to take a wait-and-see approach. Confusion about new recommendations contributes to slow acceptance, as can complex recommendations that make it hard for doctors to choose how they will treat or screen for certain conditions. No matter the reason, not following the latest guidelines can deprive our patients from receiving the best contemporary care.
ACOG guidelines are not mandates, and there are no ACOG police that enforce their use. However, staying abreast of new research, recommendations, and standards of care is the hallmark of engaged and committed professionals. We owe it to our patients to be up to date on discussions that may affect their health care.
I know that in busy practices, it can be challenging to keep up with research. I urge Fellows to read through new guidelines as they are issued each month in the Green Journal. If you find yourself with guideline-related questions, ACOG’s Practice Division available to assist you.
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