Findings from the Fund's 2003 National Survey of Physicians and Quality of Care indicate that while many U.S. doctors have adopted some of the practices associated with high-quality care, there is plenty of room for improvement. As reported by former Fund vice president Anne-Marie J. Audet, M.D., and colleagues in the April 2006 issue of
Archives of Internal Medicine,
(6) a majority of the doctors surveyed were providing some degree of patient-centered care—one of the core components of quality identified by the Institute of Medicine. For example, about two-thirds of physicians said they were always or often able to provide same-day appointments to patients, and a similar proportion said they received timely information about patient referrals.
But in other important quality areas—use of information technology, practicing team-based care, collecting and using feedback from patients—physicians are not faring so well. Three-quarters of primary care physicians said they experienced problems having access to patients' medical records, test results, or other relevant information at the time of scheduled visits.
Only about half sent patients reminder notices about regular preventive or follow-up care. Notably, physicians in larger practices appeared more likely to adopt patient-centered practices than did solo physicians.
Another article by Fund staff, published in the May/June 2005 issue of
Health Affairs, continues to have an impact in the field.
(7) The study, which found that the majority of physicians are not actively engaged in quality improvement activities, was selected in June 2006 by the Thomson-Scientific Essential Science Indicators (ESI) as a "Fast Breaking Paper," one of the most frequently cited in the social sciences.
(8) ESI covers more than 11,000 journals from around the world in 22 fields of research. The study also was among the 25 most frequently viewed articles in
Health Affairs in 2005.
To engage physicians in quality measurement and improvement, particularly those working in smaller practices, the Fund and the American Board of Internal Medicine (ABIM) Foundation launched the "Putting Quality into Practice" initiative. Project investigators interviewed 39 physicians in solo and small group practices who have successfully introduced systematic improvements in their practices. Drawing on this wealth of firsthand experience, they developed a compendium of best practices for physician-led quality improvement. An accompanying DVD video profiles 10 physicians who have improved patient care and increased efficiency through relatively simple, easily implemented interventions.
(9) Since March 2006, the ABIM foundation has fulfilled more than 2,000 requests for the video.
