Internists' attitudes about clinical practice guidelines

Area of Science:

• Internal Medicine
• Healthcare Policy
• Clinical Practice Guidelines

Background:

• Practice guidelines are increasingly prevalent in healthcare.
• Understanding physician perspectives is crucial for guideline implementation.
• The American College of Physicians (ACP) is a key organization issuing guidelines.

Purpose of the Study:

• To evaluate internists' familiarity with and confidence in various practice guidelines.
• To assess internists' attitudes towards the potential impact of practice guidelines on healthcare quality, costs, and practice satisfaction.

Main Methods:

• A cross-sectional survey was administered to a random sample of American College of Physicians members.
• 1513 internists responded to the self-administered questionnaire (60% response rate).

Main Results:

• Familiarity with guidelines ranged significantly, from 11% (ACP exercise treadmill testing) to 59% (National Cholesterol Education Program).
• Confidence in guidelines varied, with 82% trusting ACP guidelines versus 6% for Blue Cross and Blue Shield guidelines.
• Physicians anticipated guidelines could improve quality (70%) but also increase costs (43%) and reduce practice satisfaction (34%).

Conclusions:

• Most internists acknowledged potential benefits of practice guidelines.
• Concerns were raised about the impact of guidelines on physician autonomy, healthcare costs, and job satisfaction.