Deskilling and adaptation among primary care physicians using two work innovations.

Area of Science:

• Health Services Research
• Medical Innovation Studies
• Physician Practice Patterns

Background:

• The U.S. healthcare system has seen innovations aimed at improving care quality and managerial control.
• Examining physician deskilling and their active participation in this process due to innovation use is crucial.

Purpose of the Study:

• To investigate how primary care physicians perceive and experience deskilling from health care innovations.
• To understand the role of physician adaptation and the healthcare business model in deskilling outcomes.

Main Methods:

• Interviews with 78 U.S. primary care physicians.
• Computer analysis of transcribed data using open coding and pattern recognition.
• Examination of electronic medical records and clinical guidelines adoption.

Main Results:

• Physicians report deskilling outcomes: decreased clinical knowledge, patient trust, and decision-making confidence.
• Physicians actively participate in deskilling through adaptive choices with innovations.
• The primary care business model intensifies the deskilling effects of these innovations.

Conclusions:

• Physician deskilling is a tangible outcome of healthcare innovation use.
• Deskilling results from physician actions and contextual pressures.
• Healthcare organizations should mitigate pressures and examine innovation costs/benefits.