Clinical flow charts or algorithms are becoming an increasingly popular means of summarizing the management of a given clinical situation. However they vary greatly in complexity between authors, making comparisons difficult, and detracting from their overall usefulness to medical personnel. We have therefore reviewed the strengths and weaknesses of many published algorithms. As a result of both this and our own experience with clinical algorithms we have identified seven essential elements of clinical management. We believe that acceptance of these elements would improve the efficiency of clinical algorithms, both as a teaching format and as an aid to clinical management.