Physician thoughts on unnecessary noninvasive imaging and decision support software: A qualitative study
| Autor: | Kimberly Findley, Ivette Magaly Freytes, Rebecca J. Beyth, David E. Winchester, Magda Schmitzberger |
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| Rok vydání: | 2020 |
| Předmět: |
Noninvasive imaging
medicine.medical_specialty Decision support system business.industry 030503 health policy & services Medicine (miscellaneous) 03 medical and health sciences Philosophy Issues ethics and legal aspects 0302 clinical medicine Unnecessary Procedure Medical imaging Medicine Medical physics 030212 general & internal medicine 0305 other medical science business Qualitative research |
| Zdroj: | Clinical Ethics. 15:141-147 |
| ISSN: | 1758-101X 1477-7509 |
| DOI: | 10.1177/1477750920927166 |
| Popis: | Objective Gather information from physicians about factors contributing to unnecessary noninvasive imaging and impact of possible solutions. Methods Qualitative study of 14 physicians using a phenomenological approach and the Theoretical Domains Framework. Results Most participants ( n = 9) self-reported that >10% of the imaging tests they order are unnecessary. External sources of pressure included: peer-review, patient demands, nursing expectations, specialist requests (social demands), as well as prior experience with patient advocates, and the compensation and pension system (environmental context). Internal sources of pressure included reliance on anecdote (emotion), self-doubt about diagnoses (beliefs about capabilities), and fear of missing a diagnosis and of professional liability (beliefs about consequences). Participants expressed both optimism and concern about potential solutions, such as adopting decision support software. Conclusion Physicians are under pressure from multiple sources to order unnecessary imaging. Peer review, nursing expectations, and perceptions about Veteran compensation and pension are newly reported contributing factors. |
| Databáze: | OpenAIRE |
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