A central feature of general practice is the use of time in the management of patients and their illnesses. The use of active interventions such as investigations or therapies within the context of this dimension has implications for the development of clinical guidelines for primary care. Importantly, their recommendations of best practice must be compatible with the complexities of the holistic relationship between GP and patient. Many existing guidelines adopt a reductionist, algorithmic approach, losing applicability and relevance to primary care in the process. Here we identify the key features in the primary care management of the patient with dyspepsia, and examine the utility of existing guidelines for the management of Helicobacter pylori infection. Through this comparative analysis, the scope and nature of primary care-centred management guidelines are identified.