Academic physicians' views on low-value services and the choosing wisely campaign: A qualitative study
| Autor: | Yesenia Miranda, Jordan Goldberg, Linda M. Gerber, Meredith Lash-Dardia, Tara F. Bishop, Victoria Fener, Meagan Cea, Robert Kim, Peter A D Steel, Jennifer Lee, Elaine Mechanic |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Decision support system Medical psychology Faculty Medical media_common.quotation_subject education MEDLINE Medical Overuse 030204 cardiovascular system & hematology Unnecessary Procedures 03 medical and health sciences 0302 clinical medicine Physicians Medicine Humans 030212 general & internal medicine Qualitative Research media_common Medical education business.industry Health Policy Behavior change Public relations Focus Groups Focus group United States Hospital medicine Female business Qualitative research Reputation Program Evaluation |
| Zdroj: | Healthcare (Amsterdam, Netherlands). 5(1-2) |
| ISSN: | 2213-0772 |
| Popis: | Background In 2012, the American Board of Internal Medicine (ABIM) Foundation launched a campaign called Choosing Wisely which was intended to start a national dialogue on services that are not medically necessary. More research is needed on the in-depth reasons why doctors overuse low-value services, their views on Choosing Wisely specifically, and ways to help them change their practice patterns. Methods We performed a qualitative study of focus groups with physicians to explore their views on the problem of overuse of low-value services, the reasons why they overuse, and ways that they think could be effective at curbing overuse. Participants were attendings in the fields of emergency medicine, internal medicine, hospital medicine, and cardiology. Results All physicians felt that overuse of low-value services was a significant problem. Physicians frequently cited that patient expectations drove the use of low-value services and lack of time was the most cited reason why behavior change was difficult. Facilitators that could promote behavior change included decision support through the electronic medical record, motivation to maintain their reputation among their colleagues, internal motivation to be a good doctor, objective data showing their rates of overuse, alignment of institutional goals, and forums to discuss evidence and new research. Conclusions and implications In focus groups with physicians, we found that physicians perceived that overuse of low-value services was a problem. Participants cited many barriers to behavior change. Methods that help address patient expectations, physician time, and social norms may help physicians reduce their use of low-value services. |
| Databáze: | OpenAIRE |
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