Guidelines, like medical care,
must be evidence-based,
reduce unnecessary variation
in care, and always put the
safety of patients first.
*American College of Surgeons. Statement on the Use of Proprietary Guidelines by
Managed Care Organizations. 1998; 83( 3): 33-34.
The American College of Surgeons (ACS) Board of Governors’ Surgical Care Delivery Workgroup developed
the following revised statement, which the ACS Board of Regents approved at its June 2017 meeting in
Chicago, IL. The original statement was developed by the Board of Governors and approved by the Board
of Regents in 1998 as the Statement on the Use of Proprietary Guidelines by Managed Care Organizations.*
Revised Statement on the Development
and Use of Proprietary Guidelines for
Accountable Patient-Centered Care
The ACS is committed to protecting the patient’s health and well-being and the physician’s role in delivering efficient,
appropriate, and comprehensive health care.
The ACS Board of Governors recognizes new government
regulations and alternative payment models are transforming
the delivery of care throughout the U.S. To ensure the voice
of physicians and surgeons is audible in the new health care
landscape, the ACS Board of Governors is proactively putting
forth guidelines on the role of the patient, the physician, and
the government in health care.
General concepts about guidelines
•Guidelines, like medical care, must be evidence-based, reduce
unnecessary variation in care, and always put the safety of
•Guidelines should allow for variations in patient condition
and provide options to account for severity of illness and
•Guidelines should allow for local resource and staff considerations, regional differences in community standards of care,
and community needs.
•Guidelines should be formulated to consider the totality of an
episode of care. For example, discharge criteria should consider
the aftercare resources that are available to the patient, such as
convalescent care, home care, hospice care, family availability,
and so on.