Skip Navigation LinksHome > April/June 2013 - Volume 36 - Issue 2 > Open Questions Concerning Influences on Clinical Decision Ma...
Journal of Ambulatory Care Management:
doi: 10.1097/JAC.0b013e31828596de
Original Articles

Open Questions Concerning Influences on Clinical Decision Making

Davidson, Stephen M. PhD

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Abstract

Efforts to influence utilization of services to bring down spending and to improve quality of care have largely failed. A critical reason is that most attention has focused on dysfunctional financial incentives without considering other factors that also influence physicians' utilization decisions. In this article, after providing a framework for ideal physician-patient interactions, questions are also raised about other influences, including physicians' impulse to help patients, professional codes of ethics, the threat of malpractice claims, and the leadership of health care organizations. An Appendix contains a summary of the literature on these factors.

© 2013 Lippincott Williams & Wilkins, Inc.

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