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Use and Perceptions of Clinical Practice Guidelines by Internal Medicine Physicians

Center for Clinical and Genetic Economics, Duke Clinical Research Institute

Venita DePuy, MStat

INC Research, Raleigh, North Carolina

Joseph M. Allen, MA

American College of Cardiology, Bethesda, Maryland

Kevin P. Weinfurt, PhD

Center for Clinical and Genetic Economics, Duke Clinical Research Institute, kevin.weinfurt{at}duke.edu, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina

The authors sought to explore the use and perceptions of clinical practice guidelines among internal medicine physicians. Through a Web-based survey, 201 board-certified internal medicine physicians rated their opinions on several statements using 7-point Likert scales. Most respondents (74.7%) felt that guidelines were suitable for at least half of their patients, although a failure to take comorbid conditions into account was a frequently cited barrier. For patients with cardiovascular disease, there was no difference between individual internists' perceptions of their own compliance with guidelines and their estimates of cardiologists' compliance (P = .14). A large majority of respondents (70.7%) believed that guideline committee member participation in industry-funded research introduces bias into guideline content (median [interquartile range], 5 [4-6]). Although most respondents felt that measuring physicians against guideline-based performance measures encourages evidence-based medicine (76.5%), opinions were split as to whether this practice distracts from patient care or compromises physician autonomy. (Am J Med Qual 2007;22:170-176)

Key Words: cardiology • guidelines • physician attitudes • physician behavior • quality measurement

American Journal of Medical Quality, Vol. 22, No. 3, 170-176 (2007)
DOI: 10.1177/1062860607300291


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