Physicians: best practice

Standing apart from the academic researchers, the Clinical Initiatives Center sees four discrete activities in the medication use process that need reform—physician prescribing, order processing, drug delivery and reporting and event capture (shown below)—mutually-exclusive intellectual divides each describing a specific problem in need of attention. Our recommended best practices address these problems, their components and their root causes. 

Similar monitoring will help physicians in responding and administering during disasters and epidemics. Among these and other issues the different responsibilities of medical practitioners in the patient care workflow, where IT can help with compliance and best practice in providing sophisticated molecular data. 

B. Robson. 2007. The new physician as unwitting quantum mechanic Is adapting Dirac s inference system best practice for personalized medicine, genomics and proteomics Journal of Proteome Research 6(8)3114-3126. 

But, as often happens in healthcare, the situation is even more complex than it at first appears. A doctor s knowledge of the latest procedure or new medication does not always benefit the patient. Take, for example, a new, scientifically validated clinical best practice protocol. Should the physician adopt it Not necessarily. It may contain procedures or call for the use of medications with which the physician has little familiarity and no experience. It is... 

Physicians pay lip service to best practices but do not implement them. 

This part of the Exemplar HealthNet intervention included the appointment of physician mentors to help peers adopt best practices, to develop and share ideas for practice quality improvement, and to provide positive coaching for poorer performing physicians (those who were disruptive or abusive or under disciplinary review). ... 

A final area of research focuses on how the piU. can best be used by women. Physicians used to recommend pid-free hoHdays, but it is now known that there is no vaUd reason for this practice. Similarly, further research indicated that the U.S. EDA s restrictive guidelines for prescribing the piU. to women over the age of 35 are not justified, and those guidelines have been changed. EinaHy it is clear that cigarette smoking increases the risk of cardiovascular side effects, especially in women over 35 who utilize combination oral contraceptives. 

Huang JQ. Pharmacological and pharmacodynamic essentials of H(2)-receptor antagonists and proton pump inhibitors for the practicing physician. Ballieres Best Pract Res Chn Gastroenterol 2001 15 355-370. 

However, problems can and often do arise because the relationship between physician and pharmaceutical company is open to varying degrees of abuse. For example, the pharmaceutical company representative may practice selective disclosure when providing information. Without all the relevant information, the physician may not be able to adequately assess the suitability of the product for his patients use. This situation is complicated by the fact that every salesperson practices selective disclosure to some extent. It is often called "putting one s best foot forward." The difficulty lies in determining where one should draw the line. 

Other studies show that most CAM users are not abandoning Western medicine, but want the best of both worlds — an alternative caregiver with strong ties to the medical establishment and a physician who understands and makes appropriate referrals to CAM therapies. But this poses yet another problem for physicians, for studies also show that many CAM users do not tell their physicians what they are doing. Most practicing physicians know almost nothing about the potential benefits or risks of CAM because their training has focused almost exclusively on Western scientific medicine. 

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