What inhibits obstetricians implementing reliable guidelines?

What inhibits obstetricians implementing reliable guidelines? BJOG. 2020 Feb 18;: Authors: Bewley S Abstract Junior doctors used to pass on dog-eared pocket notebooks with helpful phone numbers, Mr X and Y's patient care preferences for anti-convulsants, induction timing or catheter size. We had to check the boss's wishes; certainly not the evidence or patients' view! Surely, despite plausible explanations, one intervention or other might achieve better outcomes? Why did the Great Man refuse 'his patients' to be prescribed steroids in premature labour, for example? That issue was settled from laboratory science to bedside RCTs long before practice changed (Crowley BJOG. 2003 Apr;110 Suppl 20:77-8) resulting in many avoidably damaged babies and negligence cases. PMID: 32072736 [PubMed - as supplied by publisher]
Source: BJOG : An International Journal of Obstetrics and Gynaecology - Category: OBGYN Authors: Tags: BJOG Source Type: research