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Evidence-based medicine in primary care: qualitative study of family physicians
BACKGROUND: The objectives of this study were: a) to examine physician attitudes to and experience of the practice of evidence-based medicine (EBM) in primary care; b) to investigate the influence of patient preferences on clinical decision-making; and c) to explore the role of intuition in family p...
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2003
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC165430/ https://www.ncbi.nlm.nih.gov/pubmed/12740025 http://dx.doi.org/10.1186/1471-2296-4-6 |
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author | Tracy, C Shawn Dantas, Guilherme Coelho Upshur, Ross EG |
author_facet | Tracy, C Shawn Dantas, Guilherme Coelho Upshur, Ross EG |
author_sort | Tracy, C Shawn |
collection | PubMed |
description | BACKGROUND: The objectives of this study were: a) to examine physician attitudes to and experience of the practice of evidence-based medicine (EBM) in primary care; b) to investigate the influence of patient preferences on clinical decision-making; and c) to explore the role of intuition in family practice. METHOD: Qualitative analysis of semi-structured interviews of 15 family physicians purposively selected from respondents to a national survey on EBM mailed to a random sample of Canadian family physicians. RESULTS: Participants mainly welcomed the promotion of EBM in the primary care setting. A significant number of barriers and limitations to the implementation of EBM were identified. EBM is perceived by some physicians as a devaluation of the 'art of medicine' and a threat to their professional/clinical autonomy. Issues regarding the trustworthiness and credibility of evidence were of great concern, especially with respect to the influence of the pharmaceutical industry. Attempts to become more evidence-based often result in the experience of conflicts. Patient factors exert a powerful influence on clinical decision-making and can serve as trumps to research evidence. A widespread belief that intuition plays a vital role in primary care reinforced views that research evidence must be considered alongside other factors such as patient preferences and the clinical judgement and experience of the physician. DISCUSSION: Primary care physicians are increasingly keen to consider research evidence in clinical decision-making, but there are significant concerns about the current model of EBM. Our findings support the proposed revisions to EBM wherein greater emphasis is placed on clinical expertise and patient preferences, both of which remain powerful influences on physician behaviour. |
format | Text |
id | pubmed-165430 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2003 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-1654302003-07-16 Evidence-based medicine in primary care: qualitative study of family physicians Tracy, C Shawn Dantas, Guilherme Coelho Upshur, Ross EG BMC Fam Pract Research Article BACKGROUND: The objectives of this study were: a) to examine physician attitudes to and experience of the practice of evidence-based medicine (EBM) in primary care; b) to investigate the influence of patient preferences on clinical decision-making; and c) to explore the role of intuition in family practice. METHOD: Qualitative analysis of semi-structured interviews of 15 family physicians purposively selected from respondents to a national survey on EBM mailed to a random sample of Canadian family physicians. RESULTS: Participants mainly welcomed the promotion of EBM in the primary care setting. A significant number of barriers and limitations to the implementation of EBM were identified. EBM is perceived by some physicians as a devaluation of the 'art of medicine' and a threat to their professional/clinical autonomy. Issues regarding the trustworthiness and credibility of evidence were of great concern, especially with respect to the influence of the pharmaceutical industry. Attempts to become more evidence-based often result in the experience of conflicts. Patient factors exert a powerful influence on clinical decision-making and can serve as trumps to research evidence. A widespread belief that intuition plays a vital role in primary care reinforced views that research evidence must be considered alongside other factors such as patient preferences and the clinical judgement and experience of the physician. DISCUSSION: Primary care physicians are increasingly keen to consider research evidence in clinical decision-making, but there are significant concerns about the current model of EBM. Our findings support the proposed revisions to EBM wherein greater emphasis is placed on clinical expertise and patient preferences, both of which remain powerful influences on physician behaviour. BioMed Central 2003-05-09 /pmc/articles/PMC165430/ /pubmed/12740025 http://dx.doi.org/10.1186/1471-2296-4-6 Text en Copyright © 2003 Tracy et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. |
spellingShingle | Research Article Tracy, C Shawn Dantas, Guilherme Coelho Upshur, Ross EG Evidence-based medicine in primary care: qualitative study of family physicians |
title | Evidence-based medicine in primary care: qualitative study of family physicians |
title_full | Evidence-based medicine in primary care: qualitative study of family physicians |
title_fullStr | Evidence-based medicine in primary care: qualitative study of family physicians |
title_full_unstemmed | Evidence-based medicine in primary care: qualitative study of family physicians |
title_short | Evidence-based medicine in primary care: qualitative study of family physicians |
title_sort | evidence-based medicine in primary care: qualitative study of family physicians |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC165430/ https://www.ncbi.nlm.nih.gov/pubmed/12740025 http://dx.doi.org/10.1186/1471-2296-4-6 |
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