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Internists' perceptions and performance in office practice

F J Romm, B S Hulka, L W Kelly

    Southern Medical Journal
    |April 1, 1980
    PubMed
    Summary
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    Internists identified essential care for common conditions. Physical exams and lab tests were more consistently performed and recorded than patient history or management plans, aiding quality improvement.

    Area of Science:

    • Internal Medicine
    • Healthcare Quality Improvement
    • Clinical Practice Evaluation

    Background:

    • Assessing the quality of care in internal medicine is crucial for patient outcomes.
    • Identifying essential and consistently recorded care elements informs quality metrics.
    • Private practice internists' perspectives on essential care are valuable for peer review.

    Purpose of the Study:

    • To determine essential and routinely recorded care items for common conditions managed by internists.
    • To compare the performance and recording of different care components (history, exam, labs, management).
    • To provide data for quality assessment and peer review in internal medicine.

    Main Methods:

    • Thirty-one internists in private practice identified essential care items for specific patient groups.

    Related Experiment Videos

  • Patient records were reviewed to assess the routine performance and documentation of these care items.
  • Data were collected on the evaluation and management of patients with diabetes, hypertension, dysuria/frequency, and general examinations.

    • Main Results:

    • Physical examination and laboratory evaluation items were more frequently considered essential and recorded than history questions or management instructions.
    • Significant variation likely exists in the routine performance and documentation of care across different internists and patient conditions.
    • Specific lists of essential care criteria and frequently performed components were generated.

    Conclusions:

    • Physical examination and laboratory data are key, consistently documented aspects of internist care for common conditions.
    • History taking and management plan documentation may require targeted improvement efforts.
    • The generated lists can serve as a benchmark for peer review and quality improvement initiatives in internal medicine practice.