Discretionary decision making by primary care physicians and the cost of U.S. Health care.

@article{Sirovich2008DiscretionaryDM,
  title={Discretionary decision making by primary care physicians and the cost of U.S. Health care.},
  author={Brenda E Sirovich and Patricia M. Gallagher and David E. Wennberg and Elliott S. Fisher},
  journal={Health affairs},
  year={2008},
  volume={27 3},
  pages={813-23}
}
Efforts to improve the quality and costs of U.S. health care have focused largely on fostering physician adherence to evidence-based guidelines, ignoring the role of clinical judgment in more discretionary settings. We surveyed primary care physicians to assess variability in discretionary decision making and evaluate its relationship to the cost of health care. Physicians in high-spending regions see patients back more frequently and are more likely to recommend screening tests of unproven… CONTINUE READING
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