16 results on '"Lehmann, Lisa Soleymani"'
Search Results
2. Ethical Considerations in Precision Medicine and Genetic Testing in Internal Medicine Practice: A Position Paper From the American College of Physicians.
- Author
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Lehmann LS, Snyder Sulmasy L, and Burke W
- Subjects
- Genetic Testing, Humans, Internal Medicine, Precision Medicine, United States, Internship and Residency, Physicians
- Abstract
This American College of Physicians position paper aims to inform ethical decision making for the integration of precision medicine and genetic testing into clinical care. Although the positions are primarily intended for practicing physicians, they may apply to other health care professionals and can also inform how health care systems, professional schools, and residency programs integrate genomics into educational and clinical settings. Addressing the challenges of precision medicine and genetic testing will guide ethical and responsible implementation to improve health outcomes.
- Published
- 2022
- Full Text
- View/download PDF
3. The Impact of Physician Social Media Behavior on Patient Trust.
- Author
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Fatollahi JJ, Colbert JA, Agarwal P, Lee JL, Lehmann EY, Yuan N, Lehmann LS, and Chretien KC
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Alcoholic Intoxication, Communication, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Racism, Respect, Surveys and Questionnaires, United States, Young Adult, Attitude, Physician-Patient Relations, Physicians, Professionalism, Social Media, Trust
- Abstract
Introduction: Institutions have developed professionalism policies to help guide physician social media behavior in light of professionalism lapses that have resulted in serious consequences. Prior research has gathered perspectives on online professionalism; however, the public's views remain poorly understood. Importantly, the impact of physician social media behavior on patient trust is unknown. Methods: To determine whether patients' trust might change based on their physicians' social media behavior, we conducted a cross-sectional survey across three U.S. cities ( n = 491). The survey assessed patient trust using hypothetical scenarios. Results: Most respondents reported they would have less trust if their physician posted racist comments online, wrote a disrespectful patient narrative, appeared intoxicated in a photograph, or wrote profanity. Respondent age and education impacted change in trust. Conclusions: We conclude that physicians' social media behavior may affect patient trust. Better understanding of how physicians' online presence impacts their relationships with patients can help guide policy and inform educational efforts.
- Published
- 2020
- Full Text
- View/download PDF
4. The Effects of Public Disclosure of Industry Payments to Physicians on Patient Trust: A Randomized Experiment.
- Author
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Hwong AR, Sah S, and Lehmann LS
- Subjects
- Adult, Conflict of Interest, Disclosure standards, Drug Industry standards, Female, Humans, Internet ethics, Internet standards, Male, Middle Aged, Physicians standards, Pilot Projects, Young Adult, Disclosure ethics, Drug Industry ethics, Physician-Patient Relations ethics, Physicians ethics, Trust
- Abstract
Background: Financial ties between physicians and the pharmaceutical and medical device industry are common, but little is known about how patient trust is affected by these ties., Objective: The purpose of this study was to evaluate how viewing online public disclosure of industry payments affects patients' trust ratings for physicians, the medical profession, and the pharmaceutical and medical device industry., Design: This was a randomized experimental evaluation., Participants: There were 278 English-speaking participants over age 18 who had seen a healthcare provider in the previous 12 months who took part in the study., Interventions: Participants searched for physicians on an online disclosure database, viewed payments from industry to the physicians, and assigned trust ratings. Participants were randomized to view physicians who received no payment ($0), low payment ($250-300), or high payment (>$13,000) from industry, or to a control arm in which they did not view the disclosure website. They also were asked to search for and then rate trust in their own physician., Main Measures: Primary outcomes were trust in individual physician, medical profession, and industry. These scales measure trust as a composite of honesty, fidelity, competence, and global trust., Key Results: Compared to physicians who received no payments, physicians who received payments over $13,000 received lower ratings for honesty [mean (SD): 3.36 (0.86) vs. 2.75 (0.95), p < 0.001] and fidelity [3.19 (0.65) vs. 2.89 (0.68), p = 0.01]. Among the 7.9% of participants who found their own physician on the website, ratings for honesty and fidelity decreased as the industry payment to the physician increased (honesty: Spearman's ρ = -0.52, p = 0.02; fidelity: Spearman's ρ = -0.55, p = 0.01). Viewing the disclosure website did not affect trust ratings for the medical profession or industry., Conclusions: Disclosure of industry payments to physicians affected perceptions of individual physician honesty and fidelity, but not perceptions of competence. Disclosure did not affect trust ratings for the medical profession or the pharmaceutical and medical device industry. ClinicalTrials.gov identifier: NCT02179632 ( https://clinicaltrials.gov/ct2/show/NCT02179632 ).
- Published
- 2017
- Full Text
- View/download PDF
5. 'Speaking up' about patient safety concerns and unprofessional behaviour among residents: validation of two scales.
- Author
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Martinez W, Etchegaray JM, Thomas EJ, Hickson GB, Lehmann LS, Schleyer AM, Best JA, Shelburne JT, May NB, and Bell SK
- Subjects
- Academic Medical Centers, Adult, Factor Analysis, Statistical, Female, Humans, Internship and Residency, Male, Organizational Culture, Psychometrics, Reproducibility of Results, United States, Attitude of Health Personnel, Patient Safety, Physicians psychology, Professional Misconduct, Surveys and Questionnaires standards
- Abstract
Objective: To develop and test the psychometric properties of two new survey scales aiming to measure the extent to which the clinical environment supports speaking up about (a) patient safety concerns and (b) unprofessional behaviour., Method: Residents from six large US academic medical centres completed an anonymous, electronic survey containing questions regarding safety culture and speaking up about safety and professionalism concerns., Results: Confirmatory factor analysis supported two separate, one-factor speaking up climates (SUCs) among residents; one focused on patient safety concerns (SUC-Safe scale) and the other focused on unprofessional behaviour (SUC-Prof scale). Both scales had good internal consistency (Cronbach's α>0.70) and were unique from validated safety and teamwork climate measures (r<0.85 for all correlations), a measure of discriminant validity. The SUC-Safe and SUC-Prof scales were associated with participants' self-reported speaking up behaviour about safety and professionalism concerns (r=0.21, p<0.001 and r=0.22, p<0.001, respectively), a measure of concurrent validity, while teamwork and safety climate scales were not., Conclusions: We created and provided evidence for the reliability and validity of two measures (SUC-Safe and SUC-Prof scales) associated with self-reported speaking up behaviour among residents. These two scales may fill an existing gap in residency and safety culture assessments by measuring the openness of communication about safety and professionalism concerns, two important aspects of safety culture that are under-represented in existing metrics., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
- Published
- 2015
- Full Text
- View/download PDF
6. Improving completion of advance directives in the primary care setting: a randomized controlled trial.
- Author
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Heiman H, Bates DW, Fairchild D, Shaykevich S, and Lehmann LS
- Subjects
- Adult, Advance Care Planning statistics & numerical data, Age Factors, Aged, Attitude of Health Personnel, Chronic Disease, Female, Health Knowledge, Attitudes, Practice, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Outcome Assessment, Health Care, Patient Acceptance of Health Care statistics & numerical data, Physicians statistics & numerical data, Practice Patterns, Physicians' standards, Practice Patterns, Physicians' statistics & numerical data, Sex Factors, Total Quality Management organization & administration, Advance Care Planning standards, Correspondence as Topic, Patient Acceptance of Health Care psychology, Physicians psychology, Primary Health Care standards, Reminder Systems standards
- Abstract
Background: Since 1991, hospitals have asked patients whether they have advance directives, but few patients complete these documents. We assessed two simple interventions to improve completion of advance directives among elderly or chronically ill outpatients., Methods: We conducted a cluster randomized controlled trial involving 1079 patients from five general medicine clinics that were affiliated with an academic medical center. Patients were either > or =70 years of age or > or =50 years old with a chronic illness. The study comprised three arms: physician reminders recommending documentation of advance directives, physician reminders plus mailing advance directives to patients together with educational literature, or neither intervention (control). The main outcome measure was completion of an advance directive., Results: After 28 weeks, 1.5% (5/332) of patients in the physician reminder group, 14% (38/277) in the physician reminder plus patient mailing group, and 1.8% (5/286) in the control group had completed advance directives. In multivariate analyses, patients in the physician reminder plus patient mailing group were much more likely than controls to have completed advance directives (odds ratio [OR] = 5.9; 95% confidence interval [CI]: 1.5 to 22), whereas patients in the physician reminder-only group were no more likely than controls to have completed advance directives (OR = 0.88; 95% CI: 0.21 to 3.7)., Conclusion: Mailing health care proxy and living will forms and literature to patients before an appointment at which their physicians received a reminder about advance directives yielded a small but significant improvement in completion of these documents. A physician reminder alone did not have an effect.
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- 2004
- Full Text
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7. Doctors' duty to provide abortion information.
- Author
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Oberman, Michelle and Lehmann, Lisa Soleymani
- Subjects
ABORTION ,PHYSICIANS ,UNWANTED pregnancy ,PROFESSIONAL ethics ,HEALTH policy ,REPRODUCTIVE rights - Abstract
With abortion remaining legal in over half of the country and a proliferation of websites offering information on how to access abortion medications, for those who know where to look, there are sound options for safely ending an unwanted early-stage pregnancy. But not all patients have equal access to reliable information. This Article addresses the urgent downstream harms caused by the lack of access to abortion information, and argues that in view of these consequences, regardless of abortion's legal status, clinicians have a duty to provide their patients with abortion information. We begin by documenting clinicians' hesitation to share abortion information, drawing on our interviews with 25 doctors practicing medicine in a state where abortion is criminalized. Next, we explain why clinicians are duty-bound to provide all-options counseling. We then consider whether such duties shift where abortion is criminalized. After identifying the limited legal risks associated with supplying abortion information, and showing how, by requiring all-options counseling, professional societies might reduce risks to patients and clinicians, we conclude that, regardless of the legal status of abortion, clinicians have a professional responsibility to share basic abortion information – including treatment options and how to access those options. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
8. Ethical Obligations Regarding Short-Term Global Health Clinical Experiences: An American College of Physicians Position Paper.
- Author
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DeCamp, Matthew, Lehmann, Lisa Soleymani, Jaeel, Pooja, and Horwitch, Carrie
- Subjects
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MEDICAL care , *MEDICAL ethics , *PHYSICIANS , *HEALTH promotion , *PUBLIC health - Abstract
This American College of Physicians position paper aims to inform ethical decision making surrounding participation in short term global health clinical care experiences. Although the positions are primarily intended for practicing physicians, they may apply to other health care professionals and should inform how institutions, organizations, and others structure short-term global health experiences. The primary goal of short-term global health clinical care experiences is to improve the health and well-being of the individuals and communities where they occur. In addition, potential benefits for participants in global health include increased awareness of global health issues, new medical knowledge, enhanced physical diagnosis skills when practicing in low technology settings, improved language skills, enhanced cultural sensitivity, a greater capacity for clinical problem solving, and an improved sense of self-satisfaction or professional satisfaction. However, these activities involve several ethical challenges. Addressing these challenges is critical to protecting patient welfare in all geographic locales, promoting fair and equitable care globally, and maintaining trust in the profession. This paper describes 5 core positions that focus on ethics and the clinical care context and provides case scenarios to illustrate them. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
9. Hidden Curricula, Ethics, and Professionalism: Optimizing Clinical Learning Environments in Becoming and Being a Physician: A Position Paper of the American College of Physicians.
- Author
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Lehmann, Lisa Soleymani, Sulmasy, Lois Snyder, Desai, Sanjay, and ACP Ethics, Professionalism and Human Rights Committee
- Subjects
- *
PHYSICIANS , *ETHICS , *PROFESSIONALISM , *MEDICAL schools , *ROLE models - Abstract
Much of what is formally taught in medicine is about the knowledge, skills, and behaviors required of a physician, including how to express compassion and respect for patients at the bedside. What is learned, however, includes not only admirable qualities but also behaviors and qualities that are inconsistent with ethics and professionalism. Positive role models may reinforce the character and values the profession seeks to cultivate; negative ones directly contradict classroom lessons and expectations of patients, society, and medical educators. These positive and negative lessons, which are embedded in organizational structure and culture, are the hidden curricula conveyed in medical schools, residency programs, hospitals, and clinics. This position paper from the American College of Physicians focuses on ethics, professionalism, and the hidden curriculum. It provides strategies for revealing what is hidden to foster the development of reflective and resilient lifelong learners who embody professionalism and clinicians who are, and are perceived as, positive role models. Making the hidden visible and the implicit explicit helps to create a culture reflecting medicine's core values. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
10. The Effects of Public Disclosure of Industry Payments to Physicians on Patient Trust: A Randomized Experiment.
- Author
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Hwong, Alison, Sah, Sunita, Lehmann, Lisa, Hwong, Alison R, and Lehmann, Lisa Soleymani
- Subjects
DISCLOSURE ,INDUSTRIES ,PHARMACEUTICAL industry ,MEDICAL equipment industry ,PHYSICIANS ,MEDICAL personnel ,INTERNET standards ,COMPARATIVE studies ,CONFLICT of interests ,INTERNET ,RESEARCH methodology ,MEDICAL cooperation ,PHYSICIAN-patient relations ,RESEARCH ,STATISTICAL sampling ,TRUST ,PILOT projects ,EVALUATION research ,RANDOMIZED controlled trials ,STANDARDS - Abstract
Background: Financial ties between physicians and the pharmaceutical and medical device industry are common, but little is known about how patient trust is affected by these ties.Objective: The purpose of this study was to evaluate how viewing online public disclosure of industry payments affects patients' trust ratings for physicians, the medical profession, and the pharmaceutical and medical device industry.Design: This was a randomized experimental evaluation.Participants: There were 278 English-speaking participants over age 18 who had seen a healthcare provider in the previous 12 months who took part in the study.Interventions: Participants searched for physicians on an online disclosure database, viewed payments from industry to the physicians, and assigned trust ratings. Participants were randomized to view physicians who received no payment ($0), low payment ($250-300), or high payment (>$13,000) from industry, or to a control arm in which they did not view the disclosure website. They also were asked to search for and then rate trust in their own physician.Main Measures: Primary outcomes were trust in individual physician, medical profession, and industry. These scales measure trust as a composite of honesty, fidelity, competence, and global trust.Key Results: Compared to physicians who received no payments, physicians who received payments over $13,000 received lower ratings for honesty [mean (SD): 3.36 (0.86) vs. 2.75 (0.95), p < 0.001] and fidelity [3.19 (0.65) vs. 2.89 (0.68), p = 0.01]. Among the 7.9% of participants who found their own physician on the website, ratings for honesty and fidelity decreased as the industry payment to the physician increased (honesty: Spearman's ρ = -0.52, p = 0.02; fidelity: Spearman's ρ = -0.55, p = 0.01). Viewing the disclosure website did not affect trust ratings for the medical profession or industry.Conclusions: Disclosure of industry payments to physicians affected perceptions of individual physician honesty and fidelity, but not perceptions of competence. Disclosure did not affect trust ratings for the medical profession or the pharmaceutical and medical device industry. ClinicalTrials.gov identifier: NCT02179632 ( https://clinicaltrials.gov/ct2/show/NCT02179632 ). [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
11. How Primary Care Physicians Integrate Price Information into Clinical Decision-Making.
- Author
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Schiavoni, Katherine, Lehmann, Lisa, Guan, Wendy, Rosenthal, Meredith, Sequist, Thomas, Chien, Alyna, Schiavoni, Katherine H, Lehmann, Lisa Soleymani, Sequist, Thomas D, and Chien, Alyna T
- Subjects
PHYSICIANS ,PRIMARY care ,OUTPATIENT medical care ,MEDICAL care ,MEDICAL practice ,DECISION making ,HEALTH attitudes ,PHYSICIAN-patient relations ,GENERAL practitioners ,USER charges ,QUALITATIVE research ,CROSS-sectional method ,PSYCHOLOGY - Abstract
Background: Little is known about how primary care physicians (PCPs) in routine outpatient practice use paid price information (i.e., the amount that insurers finally pay providers) in daily clinical practice.Objective: To describe the experiences of PCPs who have had paid price information on tests and procedures for at least 1 year.Design: Cross-sectional study using semi-structured interviews and the constant comparative method of qualitative analysis.Participants: Forty-six PCPs within an accountable care organization.Intervention: Via the ordering screen of their electronic health record, PCPs were presented with the median paid price for commonly ordered tests and procedures (e.g., blood tests, x-rays, CTs, MRIs).Approach: We asked PCPs for (a) their "gut reaction" to having paid price information, (b) the situations in which they used price information in clinical decision-making separate from or jointly with patients, (c) their thoughts on who bore the chief responsibility for discussing price information with patients, and (d) suggestions for improving physician-targeted price information interventions.Key Results: Among "gut reactions" that ranged from positive to negative, all PCPs were more interested in having patient-specific price information than paid prices from the practice perspective. PCPs described that when patients' out-of-pocket spending concerns were revealed, price information helped them engage patients in conversations about how to alter treatment plans to make them more affordable. PCPs stated that having price information only slightly altered their test-ordering patterns and that they avoided mentioning prices when advising patients against unnecessary testing. Most PCPs asserted that physicians bear the chief responsibility for discussing prices with patients because of their clinical knowledge and relationships with patients. They wished for help from patients, practices, health plans, and society in order to support price transparency in healthcare.Conclusions: Physician-targeted price transparency efforts may provide PCPs with the information they need to respond to patients' concerns regarding out-of-pocket affordability rather than that needed to change test-ordering habits. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
12. Physicians as Fundraisers: Medical Philanthropy and the Doctor-Patient Relationship
- Author
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Prokopetz, Julian J. Z. and Lehmann, Lisa Soleymani
- Subjects
Medicine ,Non-Clinical Medicine ,Health Care Providers ,Physicians ,Academic Medicine ,Health Services Administration and Management ,Medical Ethics ,Science Policy ,Bioethics ,Philanthropic Funding of Science - Abstract
Lisa Lehmann and colleagues discuss how “grateful patient” programs that solicit donations from wealthy individuals who receive care may be problematic for physicians and propose policies that mitigate these risks. Please see later in the article for the Editors' Summary
- Published
- 2014
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13. Redefining Physicians' Role in Assisted Dying.
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Prokopetz, Julian J.Z. and Lehmann, Lisa Soleymani
- Subjects
- *
ADVANCE directives (Medical care) , *TERMINALLY ill , *LEGAL liability , *OBLIGATIONS (Law) , *PHYSICIANS , *RIGHT to die - Abstract
The authors propose a system that would remove physicians from direct involvement in the self-directed dying process. They describe some of the efforts and movements toward greater social and legal acceptance of the process. They also highlight findings of a survey of relatives of terminally ill patients in Oregon which reflect the perspective that some terminally ill patients wish to exercise their autonomy for their death. They discuss six primary objections to legalizing assisted dying.
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- 2012
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- View/download PDF
14. Partnering with patients to realize the benefits of social media.
- Author
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Colbert, James A. and Lehmann, Lisa Soleymani
- Subjects
MEDICAL practice ,SOCIAL media ,MEDICAL care research ,MEDICAL informatics ,MEDICAL education ,PHYSICIANS - Abstract
Despite widespread concern about the potential risks of the use of social media, we are optimistic that social networks and blogs have the potential to enhance the practice of medicine by allowing clinicians to share ideas and information within the health care community, with patients, and with the general public. In particular, we believe that there can be value in posting information related to a patient encounter on social media, but only if care has been taken to consider the consequences of such a post from the patient’s perspective. Thus, having a discussion with a patient and obtaining verbal consent before posting even deidentified patient information should become standard practice for all physicians who use social media. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
15. Caring for 'Very Important Patients'--Ethical Dilemmas and Suggestions for Practical Management.
- Author
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Alfandre, David, Clever, Sarah, Farber, Neil J., Hughes, Mark T., Redstone, Paul, and Lehmann, Lisa Soleymani
- Subjects
- *
ETHICAL problems , *VIP guests , *PATIENTS , *MEDICAL quality control , *VIGNETTES (Teaching technique) , *JUDGMENT (Psychology) , *PHYSICIANS' attitudes , *CELEBRITIES , *MEDICAL ethics , *MEDICAL protocols , *PSYCHOLOGY of physicians , *PHYSICIANS , *MEDICAL offices , *OFFICE management , *ETHICS - Abstract
The care of Very Important Patients (VIPs) is different from other patients because they may receive greater access, attention, and resources from health care staff. Although the term VIP is used regularly in the medical literature and is implicitly understood, in practice it constitutes a wide and heterogeneous group of patients that have a strong effect on health care providers. We define a VIP as a very influential patient whose individual attributes and characteristics (eg, social status, occupation, position), coupled with their behavior, have the potential to significantly influence a clinician's judgment or behavior. Physicians, celebrities, the politically powerful, and philanthropists, may all become VIPs in the appropriate context. The quality of care may be inferior because health care professionals may deviate from standard practices when caring for them. Understanding the common features among what may otherwise be very different groups of patients can help health care providers manage ethical concerns when they arise. We use a series of vignettes to demonstrate how VIPs behavior and status can influence a clinician's judgment or actions. Appreciating the ethical principles in these varied circumstances provides health care professionals with the tools to manage ethical conflicts that arise in the care of VIPs. We conclude each vignette with guidance for how health care providers and administrators can manage the ethical concern. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
16. The Effect of Price Information on the Ordering of Images and Procedures.
- Author
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Chien, Alyna T., Ganeshan, Smitha, Schuster, Mark A., Lehmann, Lisa Soleymani, Hatfield, Laura A., Koplan, Kate E., Petty, Carter R., Sinaiko, Anna D., Sequist, Thomas D., and Rosenthal, Meredith B.
- Subjects
- *
DIAGNOSTIC imaging , *MEDICAL care costs , *MEDICAL protocols , *PEDIATRICIANS , *PHYSICIANS , *STATISTICAL sampling , *THERAPEUTICS , *PHYSICIAN practice patterns , *RANDOMIZED controlled trials , *ONE-way analysis of variance , *ECONOMICS - Abstract
BACKGROUND ANO OBJECTIVES: Ordering rates for imaging studies and procedures may change if clinicians are shown the prices of those tests while they are ordering. We studied the effect of 2 forms of paid price information, single median price and paired internal/ external median prices, on how often pediatric-focused and adult-oriented clinicians (most frequently general pediatricians and adult specialists caring for pediatric-aged patients, respectively) order imaging studies and procedures for 0- to 21-year-olds. METHODS: In January 2014, we randomized 227 pediatric-focused and 279 adult-oriented clinicians to 1 of 3 study arms: Control (no price display), Single Median Price, or Paired Internal/External Median Prices (both with price display in the ordering screen of electronic health record). We used 1-way analysis of variance and paired t tests to examine how frequently clinicians (1) placed orders and (2) designated tests to be completed internally within an accountable care organization. RESULTS: For pediatric-focused clinicians, there was no significant difference in the rates at which orders were placed or designated to be completed internally across the study arms. For adult-oriented clinicians caring for children and adolescents, however, those in the Single Price and Paired Price arms placed orders at significantly higher rates than those in the Control group (Control 3.2 [SD 4.8], Single Price 6.2 [SD 6.8], P < .001 and Paired Prices 5.2 [SD 7.9], P = .04). The rate at which adult-oriented clinicians designated tests to be completed internally was not significantly different across arms. CONCLUSIONS: The effect of price information on ordering rates appears to depend on whether the clinician is pediatric-focused or adult-oriented. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
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