Navigating TNT Guidelines for Safe Use.

Guideline panels should consider the estimated clinician time needed to improve the desired outcome for one person in the targeted population, a metric that they call "time needed to treat" (TNT). Following all guideline recommendations for chronic diseases plus those for preventive and acute care would require a primary care physician with a nationally representative panel of adult patients to work an impossible 27-hour day. Guidelines will never comprise all of medicine, particularly primary care, where following too many well-intended recommendations can sometimes get in the way of being a good doctor.