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Physician Behavior Change: A Systematic Review.

Brian P Cunningham1,2, Caitlin J Bakker3, Harsh R Parikh1

  • 1Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.

Journal of Orthopaedic Trauma
|October 10, 2019
PubMed
Summary
This summary is machine-generated.

Implementing evidence-based medicine (EBM) is crucial for healthcare improvement but challenging for physicians. This review analyzes strategies for physician behavior change, finding multimodal interventions promising yet varied.

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Area of Science:

  • Health Services Research
  • Medical Education
  • Clinical Practice Improvement

Background:

  • Evidence-based medicine (EBM) is a cornerstone of modern healthcare, aiming to revolutionize practices and enhance patient outcomes.
  • Physicians encounter significant personal and professional hurdles when adopting EBM, necessitating effective strategies for behavior change.
  • Understanding these challenges is vital for successful implementation and improved healthcare standards.

Purpose of the Study:

  • To systematically review and analyze existing literature on physician behavior change strategies.
  • To identify effective interventions for promoting the adoption of evidence-based medicine practices among healthcare providers.
  • To categorize studies based on assessed outcomes to understand the impact of different interventions.

Main Methods:

  • A systematic review was conducted, evaluating 29 studies from an initial pool of 1970.
  • Studies were meticulously reviewed by two independent reviewers.
  • Research was categorized into five outcome areas: physician knowledge, test ordering, protocol compliance, medication prescription, and complication rates.

Main Results:

  • Multimodal interventions demonstrated greater effectiveness in driving physician behavior change.
  • Interventions focused on osteoporosis screening utilized educational approaches.
  • Studies on protocol compliance and prescription patterns showed heterogeneity in interventions and outcomes, making definitive conclusions difficult.
  • Physician behavior is significantly influenced by mentors, training, and past experiences, often more than by literature.

Conclusions:

  • While multimodal interventions show promise, variability in study designs hinders identification of the single most effective strategy for physician behavior change.
  • Factors beyond literature, such as mentorship and experiential learning, profoundly impact physician behavior.
  • Adopting evidence-based practices and value-centric care offers a pathway for physicians to enhance their performance and patient care.