What influences doctors' prescribing? Sore throats revisited

An audit of two practices in 1987 revealed a wide range of antibiotic prescribing for acute sore throat among the general practitioners. The data were presented at a postgraduate meeting and recommendations were made for a practice policy on antibiotic prescribing. The results of studies that looked at the objectives of treatment were included at that meeting. This paper presents a re-evaluation of the same doctors' antibiotic prescribing one-year later. Changes had occurred in the range and costs of drugs chosen, but individual doctors' prescribing rates remained broadly similar, in other words it was easier to influence what, but not whether, a doctor prescribes for this clinical condition. The existence of a prescribing 'threshold' within the individual doctor is supported.