Recent decades have witnessed the emergence of what is known as practice guidelines in all specialties of medical field. Practice guidelines are now fundamental to practice medicine all over the globe whatever the health management system is. Practice guidelines are one of the principal cornerstones that ensure the highest quality of health service delivery on the scientific, legal and economic bases. In fact, practice guidelines recommendations are general terms about the appropriate techniques to deal with different diseases, mostly without specific details.

According to the guideline recommendations, health service providers generate local protocols and clinical pathways for different diseases, including the full details according to the available resources in each locality.

Practice guidelines are general recommendations about the appropriate way to diagnose, prevent, treat and follow patients in different clinical situations across all medical fields, generated by expert panels in every specialty. Generation of practice guidelines may be based on either both the combined clinical experience and expert opinion, or based on the best quality research evidence; what is known as “evidence-based clinical practice guidelines”. Evidence-based clinical practice guidelines are now the standard form of guidelines that is respected and used to govern modern medical practice.

Generation of evidence-based clinical practice guidelines is a hard and tedious task, starting by determining the clinical situations needed to be included in the guideline, searching all literature about this situation, appraising the retrieved literature for relevance and validity, extracting the recommendations with the level of evidence for each recommendation, writing the guideline, then revising the guideline before it is issued in the final form. Each issued guideline is continually revised and updated when new evidence is published, usually every one to three years.

Due to their importance, there are many well-known scientific bodies that publish evidence-based clinical practice guidelines all over the world. One of the most famous guideline generators is the National Institute for Health and Care Excellence (NICE) in the UK (www.nice.org.uk). NICE guidelines are one of the most respectable evidence-based guidelines and clinical pathways that are distributed free of charge. The Royal College of the UK is also an important guideline generator in different medical specialties (called Green Top guidelines) and also is free of charge. Other famous bodies have an important share in generating guidelines such as the American College, the different American medical associations, Scotch Intercollegiate Guidelines Network (SIGN), Australian and New Zeeland Council, and many others. One of the best free websites search engines for guidelines is the TRIP database (https://www.tripdatabase.com).

One may ask “why to follow the guidelines?”. All physicians had learnt in the faculty of medicine how to appropriately deal with the patients. Knowledge and skills gained during the years of learning are more and more enforced by the experience gained along the years of clinical work. What can guidelines add to us?

First, it is well known that the knowledge gained during years of learning get weaker by time. In addition, experience is always affected by real life environment and is affected by many factors such as the practice of your seniors, the available equipment at the work place and even the cultural traditions. Therefore, neither knowledge nor experience guarantee ideal medical practice or ensure beast patient care. Reading guidelines remind us with the appropriate way of medical practice and patient care and continuously correct our road in medical field.

Second, continuous reading in medicine to update our knowledge is a hard task for practitioners, who are loaded with work and responsibilities along the day. Guidelines offers the most updated knowledge related to patient care in a very concise form included in few pages. Reading the guideline recommendations takes a very short time in relation to the amount of gained knowledge.

Third, the quality of published research is not guaranteed whatever the journal is. There is increasing evidence on the poor quality research published even in some of the prestigious medical journals, and although this is aggressively resisted and treated, yet the medical literature is not free of contamination. Therefore, the ordinary medical practitioner is not qualified to discriminate the high quality from the low quality research, and thus the ordinary medical practitioner is not qualified to extract evidence by himself. Guidelines offer recommendations based on the highest quality evidence guaranteed by the most powerful experts in the field.

Fourth, when the medical caregiver follows the most recent and respectable guidelines, (s) he is confident that the patient is offered the best health care that generates a sense of satisfaction on the human and moral bases. In addition, following guidelines protects the medical practitioner of medico-legal issues. This sense of protection enforces his/her confidence during work.

Despite the individual benefits, following the guidelines offers an important economic outcome for the health system. Following the guidelines, and the associated protocols and clinical pathways will result in unification of the patient care and standardization of the service delivery. This will lead to considerable reduction in the cost of health service despite the associated increase in service quality.

In conclusion, following evidence-based practice guidelines is essential for appropriate patient care nowadays, either on individual or institutional basis. Evidence-based practice guidelines benefit medical practice on scientific, practical, moral, legal and economic grounds. Every medical caregiver must be aware of the guidelines in his/her specialty, regularly read the updated versions, and follow all recommendations as much as possible according to the available resources. This will ensure the best patient care which is the final goal of medicine.