Physicians perform poorly when patients need special care
e! Science News
July 19, 2010
Patients often receive inappropriate care when their doctors fail to take into account their individual circumstances, according to a new study by the University of Illinois at Chicago and the VA Center for Management of Complex Chronic Care. The study of physician performance is the largest ever to be conducted using actors presenting as patients in doctors’ offices. It appears in the July 20 issue of Annals of Internal Medicine and was funded by the Department of Veterans Affairs.
“Physicians did quite well at following guidelines or standard approaches to care, but not so well at figuring out when those approaches were inappropriate because of a particular patient’s situation or life context,” said Dr. Saul Weiner, associate professor of medicine and pediatrics at UIC and staff physician at the Jesse Brown VA Medical Center, who was lead author of the study.
Weiner said physicians need to understand why a patient is failing, for instance, to control their asthma, rather than just increase the dose of the drugs they prescribe. Specific issues — such as the lack of health insurance, the need for less costly treatment, or difficulty understanding or following instructions — must be recognized when making clinical decisions. Inattention to such issues leads to what are called “contextual errors” in patient care. (more)