The American patient and consumer groups are increasing pressure on physicians and health care organizations to improve and document the quality of care that they deliver. A leading cause of inadequate care is the significant variations in medical practice that cannot be explained by patient differences, which persist through out the country. Managed care and the rise of consumer groups has forced health care providers and organization to begin analyzing how and why they deliver care to patients. The incorporation of quality improvement tools such as evidence-based practice guidelines have been shown to reduce practice variability, improving the process and outcomes of care. The correct development and implementation of these guidelines can be an effective tool to assist the practicing physician in improving the care delivered to his/her patient.