• Int J Qual Health Care · Apr 1998

    Understanding physicians' imaging test use in low back pain care: the role of focus groups.

    • D Shye, D K Freeborn, J Romeo, and S Eraker.
    • Center for Health Research, Kaiser Permanente Northwest Division, Portland, OR, USA. shyedi@bgumail.bgu.ac.il
    • Int J Qual Health Care. 1998 Apr 1; 10 (2): 83-91.

    ObjectiveTo gain understanding about why a controlled intervention to reduce variability in lumbar spine imaging test use rates for low back pain patients was ineffective among internal medicine and family practice physicians in a large US health maintenance organization.DesignWe retrospectively analyzed data from focus groups that had been conducted prior to the implementation of the intervention. The physicians were asked about the factors that influence their decisions to order such tests.Study ParticipantsInternal medicine and family practice physicians in the intervention group. MAIN STUDY FINDINGS: Most of the variability in physicians' imaging test ordering appeared to occur in the care of patients with back pain of non-traumatic origin who had no radicular symptoms. Within that clinical context, nonclinical factors such as patient age and work status, time constraints, access problems and ambiguity about internal referral processes were important factors in physicians' decisions. Especially relevant were tensions and conflicts the physicians face as they attempted to meet conflicting role obligations in the health maintenance organization. These tensions raised issues of patient trust in their physicians and in medical care organizations, and it appeared that imaging test orders sometimes served social and symbolic functions in resolving them.ConclusionOur findings suggest that gaining information from focus groups prior to designing physician behavior change interventions may aid the design of more effective interventions.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…