Do primary care physicians share a similar point of view? A recent study in the Archives of Internal Medicine explores this theme.
The investigators conducted a nationally representative mail survey of US primary care physicians randomly selected from the American Medical Association Physician Masterfile (response rate, 70%; n = 627).
Forty-two percent of US primary care physicians believe that patients in their own practice are receiving too much care; only 6% said they were receiving too little. The most important factors physicians identified as leading them to practice more aggressively were malpractice concerns (76%), clinical performance measures (52%), and inadequate time to spend with patients (40%). Physicians also believe that financial incentives encourage aggressive practice: 62% said diagnostic testing would be reduced if it did not generate revenue for medical subspecialists (39% for primary care physicians). Almost all physicians (95%) believe that physicians vary in what they would do for identical patients; 76% are interested in learning how aggressive or conservative their own practice style is compared with that of other physicians in their community.
So many primary care doctors believe that their patients are receiving too much care. The cause appears multifactorial and includes fear of litigation, financial incentives and insufficient time with patients.
Perhaps a peer to peer comparison could affect a change in practice or perhaps it could reinforce collective, non-evidence based practice. Most encouraging, in my view, is that many respondents were interested in feedback on their practice style.
