That physicians may disagree about appropriate care for an individual patient should come as no surprise. Diversity of physicians' backgrounds, training, and clinical practice experience is a well-documented contributor to physician-level variation in practice patterns. However, clinical practice guidelines (CPGs) are meant to reflect the best, most evidence-based care for the “average” patient and are meant to be followed by all physicians caring for those patients. Compensation in the United States will soon be adjusted on the basis of physician-level adherence to quality measures, which are often based on CPGs, and insurance coverage is increasingly based on CPG recommendations. Therefore, a high degree of consensus should be expected in CPGs for a given clinical situation.

中文翻译：

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当临床实践指南相冲突时：找到前进的道路

医师可能不同意为个别患者提供适当的护理，这不足为奇。医师背景，培训和临床实践经验的多样性是医师水平上实践模式变化的有据可查的贡献者。但是，临床实践指南（CPG）旨在反映对“平均”患者的最佳，最循证的护理，并且所有照顾这些患者的医生都应遵循。在美国，赔偿金将很快根据医师对质量度量的依从性进行调整，而质量度量通常基于CPG，而保险范围也越来越多地基于CPG的建议。因此，对于给定的临床情况，应在CPG中达成高度共识。