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June 9, 1999

Can Physician Profiles Be Trusted?

Author Affiliations

Author Affiliation: Primary Care Research Center Division of General Internal Medicine, San Francisco General Hospital, San Francisco, Calif.

JAMA. 1999;281(22):2142-2143. doi:10.1001/jama.281.22.2142

More than 25 years ago, Wennberg and Gittelsohn1 observed that communities in Vermont varied a great deal in the amount of health care they used. Many others have since duplicated these findings of variation in health care utilization across communities (ie, small-area variation). Wennberg and colleagues2 concluded that small-area variation in health care utilization could not be attributed to how sick the population was who lived in various communities, nor to differences in their health outcomes, but rather to irrational physician decision making in the setting of uncertainty.

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