Extremely intersting and actual. But I have to disagree on the proposed solution.
Guidelines pose problems (particularly clear, facing multimorbidity) because they are bad guidelines, not because they are guidelines.
You can have guidelines that say "in these circumstances, it's up to the clinician to decide on the basis of A, B and C".
The idea that a clinician in front of his/her patient isn't following some sort of rule based heuristics (which are just his/her private guidelines) has no basis.
These heuristics can be EB or not. Improving means we have to cut arbitrary decisions in favor of things that work (EB) or in favor of educated guesses by experts (tracked as research).
Does multimorbidity require our guidelines to grow exponentially because of the number of possible different circumstances? So be it. Nothing guarantees that medicine should be "simple".
Extremely intersting and actual. But I have to disagree on the proposed solution.
Guidelines pose problems (particularly clear, facing multimorbidity) because they are bad guidelines, not because they are guidelines.
You can have guidelines that say "in these circumstances, it's up to the clinician to decide on the basis of A, B and C".
The idea that a clinician in front of his/her patient isn't following some sort of rule based heuristics (which are just his/her private guidelines) has no basis.
These heuristics can be EB or not. Improving means we have to cut arbitrary decisions in favor of things that work (EB) or in favor of educated guesses by experts (tracked as research).
Does multimorbidity require our guidelines to grow exponentially because of the number of possible different circumstances? So be it. Nothing guarantees that medicine should be "simple".