- Primary Investigator:
Daniel A. Menchik - Primary Location:
University of Chicago - Grant Type & Year:
George Bennett Spring 2006 - Publication:
Publication1
Purpose
This project will reveal the strategies used by patients that enable successful input into their treatments, and indicate the conditions under which physician decisions are based on influences from colleagues or scientific research. Consequent interventions can potentially proceed in a fashion unhampered by obstacles that otherwise would have prevented successful implementation. The project seeks to indicate what conditions cause physicians to acquiesce to their patients’ requests for particular treatments and evaluate to what extent clinical research and evidence-based medical resources are used.
The specific aims of this research study are:
Specific aim 1: To identify how norms are created and change among physicians in an elite teaching hospital. The guiding questions are: How does medical practice change in the wake of changes in its knowledge base? Under what conditions can patients influence physicians’ decisions around this knowledge?
Specific aim 2: To examine the conditions under which patients influence their physicians’ decisions.
Specific aim 3: To examine physicians’ patterns of information-retrieval and related this to the type of organization in which they work.
Findings
Social network analysis of physicians and their information-collection activities. Multivariate analysis of physicians’ acquiescence to patient requests.
Paper 1: In highly-ranked hospitals, time spent conducting clinical activities is discounted by colleagues and esteem is allocated to those who spend relatively more time than others using electronic databases to search for specific articles. By contrast, physicians in lower-ranked hospitals are rewarded for engaging in clinical activity and reviewing a relatively greater range of scientific journals.
Paper 2: Patients are less likely to have influence when their physicians work in large practices. Patients who independently obtain medical information are more influential, and those with different education levels appear to vary in their patterns of interaction around this information during the encounter.
