December 1988

The Influence of General and Case-Related Experience on Primary Care Treatment Decision Making

Author Affiliations

From the Schools of Medicine (Drs Gruppen, Wolf, and Stross) and Education (Dr Van Voorhees), University of Michigan, Ann Arbor.

Arch Intern Med. 1988;148(12):2657-2663. doi:10.1001/archinte.1988.00380120103021

• In an effort to examine how general vs case-related clinical experience influenced physicians' treatment decisions, fourclinical case vignettes (rheumatoid arthritis, fever of undetermined origin, exercise-induced asthma, and cor pulmonale) were presented to 387 primary care physicians. For each case, physicians indicated (1) their willingness to proceed with treatment without seeking additional information, (2) their preferences for sources of supplementary information, and (3) their preferences for continued care responsibility. The results indicated that the nature of the particular vignette had a major impact on how physicians made treatment decisions. Also, having greater case-related experience and being younger led to greater willingness to proceed with treatment and preferences for continued care responsibility. Preferences for information sources were largely independent of either form of experience. Treatment decision making appears to be quite dependent on experience with similar problems and being up-to-date on current treatment procedures.

(Arch Intern Med 1988;148:2657-2663)