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Despite financial penalties, French physicians' knowledge of regulatory practice guidelines is poor
P Durieux1, B Gaillac, B Giraudeau
1Santé Publique, Faculté de Médecine Broussais Hôtel Dieu, Paris, France. pierre.durieux@egp.ap-hop-paris.fr
Objective:
To evaluate the level of awareness and knowledge of regulatory practice guidelines (references medicales opposables [RMOs] or regulatory medical references) implemented to control ambulatory care costs among French family physicians.
Design:
Observational study. Participants were asked to identify RMO topics among a list of actual and fictitious RMO topics and the RMOs themselves among a list of actual and fictitious RMOs.
Setting:
General practice in France.
Subjects:
Three hundred twenty-one family physicians.
Main Outcome Measure:
Average score of 100 (95% confidence interval [CI]) on the awareness of RMO topics and knowledge of the RMOs.
Results:
The average overall score was 55.8 of 100 (95% CI, 53.3-58.3) for the awareness of the RMO topics and 50.5 (95% CI, 48.3-52.7) for knowledge of the RMOs themselves-53.2 (95% CI, 51.1-55.3) for diagnostic RMOs and 47.8 (95% CI, 45.6-50.0) for therapeutic RMOs. Chance would have yielded an expected mean score of 50. A statistically significant difference was noted between the average score for actual (62.2) and fictitious (43.2) RMOs, P<.001. None of the respondents correctly identified all 24 correct answers.
Conclusion:
Despite implementation of RMO policy, the awareness and knowledge of RMOs among French family physicians seem weak. The number of RMOs and the difficulties in controlling physicians probably explain these results. Thus, it is doubtful that the RMO policy will have a long-term effect on physicians' behavior.
Insights
French family physicians show weak awareness and knowledge of regulatory medical references (RMOs) designed to control healthcare costs. This suggests RMO policies may not effectively influence physician behavior long-term.
Area of Science:
- Healthcare policy
- Medical practice management
- Public health
Background:
- Regulatory medical references (RMOs) are implemented in France to manage ambulatory care costs.
- Understanding physician awareness and knowledge of these guidelines is crucial for policy effectiveness.
Purpose of the Study:
- To assess the level of awareness and knowledge of RMOs among French family physicians.
- To evaluate the comprehension of RMO topics and specific RMOs themselves.
Main Methods:
- An observational study was conducted with 321 family physicians in France.
- Participants identified actual versus fictitious RMO topics and RMOs.
- Performance was measured by average scores on awareness and knowledge.
Main Results:
- The average overall score for awareness of RMO topics was 55.8/100, and for knowledge of RMOs was 50.5/100.
- Physicians scored higher on actual RMOs (62.2) than fictitious ones (43.2), indicating some recognition but overall low comprehension.
- No physician correctly identified all RMOs, highlighting significant knowledge gaps.
Conclusions:
- Awareness and knowledge of RMOs among French family physicians are notably weak, despite policy implementation.
- Factors such as the sheer number of RMOs and challenges in physician oversight likely contribute to these findings.
- The limited understanding raises doubts about the long-term impact of RMO policy on physician behavior.