Guidelines for treating osteoporosis issued by NICE in October 2008 were controversial throughout the consultation process and legally challenged early in 2009. The National Osteoporosis Guideline Group released an alternative set of guidelines giving doctors more choice in prescribing and including treatment for men. While experts in the UK argued about treatment choices, the American College of Physicians released guidance for US practice. The USA is often seen as an early adopter of new treatments—does this translate into its guidance for doctors?