Primary care HMO clinicians' opinions about clinical practice guidelines.

OBJECTIVE. To assess primary care clinicians' opinions about the principal goals that national guideline developers foresee for clinical practice guidelines, and about possible effects of guideline implementation that are known to concern practicing clinicians. DESIGN. Preintervention survey of attitudes conducted as part of a larger study to evaluate alternative strategies for implementing clinical practice guidelines. SETTING. Kaiser Permanente, Northwest Region, a large, group model HMO. PARTICIPANTS. Primary care clinicians (N = 211) with at least 1 year of work experience in the HMO. The response rate was 80% (N = 168). RESULTS. Clinicians' responses suggest they will not object to the implementation of specific practice guidelines in the HMO. Guidelines' information-synthesizing and consensus-building functions are likely to be welcomed. Increased guideline implementation is apparently not perceived as a threat to professional autonomy. CONCLUSIONS. Further research is recommended, using this measure, or refined versions of it, in diverse practice settings. In addition, studies are needed of the relationship between clinicians' general expectations about the effects of guidelines and their level of adherence to specific guidelines.