Doctors’ clinical judgment risks being sacrificed on the altar of protocol driven care

Abstract

Doctors’ diminishing clinical autonomy can have a series of knock-on effects, writes Zaid Al-Najjar In healthcare today, much of our work is driven by the need to fit neatly into a clinical pathway. This leaves many doctors feeling frustrated and mourning the loss of autonomy. Everything we do—from what we prescribe, the investigations that we order, to the referrals we make—seem governed by predefined pathways. It can feel like there is always someone ready to point out that what you thought was clinically necessary falls outside the pathway parameters and therefore shouldn’t have (or can’t be) done. When something goes wrong and our practice falls under the scrutiny of the medicolegal microscope, expert witnesses refer to best practice …