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Physicians' experiences and beliefs regarding informal consultation
N L Keating1, A M Zaslavsky, J Z Ayanian
1Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA.
JAMA
|September 18, 1998
Summary
Physicians commonly use informal consultations, with use varying by specialty and practice setting. Approval of this practice is linked to perceived quality of care improvements.
Area of Science:
- Medical practice and healthcare delivery
- Physician communication and collaboration
Background:
- Healthcare cost containment strategies may alter physician reliance on informal consultations.
- Understanding informal consultation patterns is crucial in evolving healthcare landscapes.
Purpose of the Study:
- To investigate physicians' utilization patterns of informal consultations.
- To explore physicians' beliefs and attitudes regarding informal consultation.
Main Methods:
- A survey was distributed to a diverse sample of Massachusetts physicians in July 1997.
- Data were collected from 705 eligible physicians across general internal medicine, pediatrics, cardiology, orthopedic surgery, and infectious diseases.
- Self-reported data on the frequency and perceived value of informal consultations were analyzed.
Main Results:
- Generalist physicians engaged in more informal consultations than specialists.
- Physicians in group practices and those with capitation-based income reported higher rates of informal consultation.
- Physician approval of informal consultation strongly correlated with their beliefs about its impact on patient care quality.
Conclusions:
- Informal consultation is prevalent and influenced by specialty, practice environment, and payment models.
- Trends toward group practice and managed care may increase informal consultation use.
- Physicians should carefully consider the quality implications of informal consultations.