ArticleHealth affairs (Project Hope)
Discretionary decision making by primary care physicians and the cost of U.S. Health care.
Article in Health affairs (Project Hope). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers.
What it found
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Who cites it
91 citing papers in PubMed.
- Using incentives to recruit physicians into behavioral trials: lessons learned from four studies.BMC research notes · 2017Trial
- Efficacy of educational video game versus traditional educational apps at improving physician decision making in trauma triage: randomized controlled trial.BMJ (Clinical research ed.) · 2017Trial
- Inpatient total thyroidectomy costs and outcomes vary regionally: A nationwide study.Laryngoscope investigative otolaryngology · 2025Article
- Geographic Variation in Operative Management of Adhesive Small Bowel Obstruction.The Journal of surgical research · 2023Article
- Strategies to Reduce Low-Value Cardiovascular Care: A Scientific Statement From the American Heart Association.Circulation. Cardiovascular quality and outcomes · 2022Review
- Opportunities to improve the quality of inpatient consultation: one hospital's investigation but an age old struggle.Israel journal of health policy research · 2022Article
- Article
- Physician Practice Pattern Variations in Common Clinical Scenarios Within 5 US Metropolitan Areas.JAMA health forum · 2022Article
- Association of Cardiology Billing Amounts With Health Care Utilization and Clinical Outcomes in Patients With Atrial Fibrillation.Journal of the American Heart Association · 2021Article
- Determinants of Medical Practice Variation Among Primary Care Physicians: Protocol for a Three Phase Study.JMIR research protocols · 2020Article
- Hospital doctors' attitudes to brief educational messages that aim to modify diagnostic test requests: a qualitative study.BMC medical informatics and decision making · 2020Article
- Association of Regional Practice Environment Intensity and the Ability of Internists to Practice High-Value Care After Residency.JAMA network open · 2020Article
- A new instrument to measure high value, cost-conscious care attitudes among healthcare stakeholders: development of the MHAQ.BMC health services research · 2020Article
- Association of Clinical Characteristics With Variation in Emergency Physician Preferences for Patients.JAMA network open · 2020Article
- Imprinting on Clinical Rotations: Multisite Survey of High- and Low-Value Medical Student Behaviors and Relationship with Healthcare Intensity.Journal of general internal medicine · 2019Article
- Characteristics of Emergency Department Visits and Select Predictors of Hospitalization for Adults With Newly Diagnosed Cancer in a Safety-Net Health System.Journal of oncology practice · 2019Article
- Influence of Peer Physicians on Intensity of End-of-Life Care for Cancer Decedents.Medical care · 2019Observational
- Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spendingf.American economic journal. Economic policy · 2019Article
- Regional Practice Patterns and Racial/Ethnic Differences in Intensity of End-of-Life Care.Health services research · 2018Article
- Protection against the overuse and underuse of health care - methodological considerations for establishing prioritization criteria and recommendations in general practice.BMC health services research · 2018Article
31 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
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 benefit and discretionary interventions compared with physicians in low-spending regions; however, both appear equally likely to recommend guideline-supported interventions. Greater attention should be paid to the local factors that influence physicians' clinical judgment in discretionary settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.