There is now good evidence that the publication of guidelines as a stand-alone exercise produces little change in clinical practice and no change in health outcome. Randomised controlled studies of the effectiveness of Continuing Medical Education (CME) and of interventions to change professional practice have clearly shown that communications restricted to the distribution of published or printed educational materials is not effective. Rather, these studies indicate that the publication and distribution of practice guidelines must be embedded in a comprehensive package of interventions reaching clinicians in their local practice site, in order to change physician performance and health outcomes.