Recently I came across the following quote while reading a discussion in the North American Menopause Society's "First to Know" newsletter. (
www.menopause.org)
With respect to a discussion on Vitamin D measurement and treatment recommendations the following quote puts potential cutting edge therapy into perspective. Dr. Robert Heaney of Creighton University, was quoted as stating, there are three decision levels that can be invoked here: the personal, the professional, and the policy decision level.
1) At the personal decision level, the physician decides what he or she will personally do.
2) At the professional decision level, the physician decides what to recommend to his or her individual patient.
3) At the policy decision level (guidelines), recommendations are made for an entire population. As one moves from the personal to the professional to the policy decision level, the recommendations become appropriately more conservative.
In the real world (especially Lipidology), caring for high and very high risk patients, thank goodness the art of practicing medicine (#2 above), not guidelines still prevails.
Tom D
