Evaluation of standards of practice for primary care physicians using 12 hypothetical cases

Concerns about the quality of medical care are increasing. As quality of medical care is difficult to measure, physicians have relied on standards based on research, consensus, or personal experience. The authors surveyed primary care physicians in Missouri to determine the presence and extent of standards of care for 12 hypothetical cases. The results demonstrate that within and between diagnoses there is both consensus and disagreement in case management. A standard of practice can be inferred for those management options achieving consensus. Further research is indicated for those options generating considerable disagreement to resolve the discrepancies in standards of care.