To fully understand the impact of reform on the nation’s health care system, researchers and other experts in health care policy must have access to accurate, timely information on physicians and their practices. In a new special issue of the Journal of General Internal Medicine (JGIM), Mathematica health policy experts Catherine DesRoches, Eugene Rich, Jim Reschovsky, Ann O’Malley, and others discuss the rationale for a new, ongoing data collection effort that includes all physicians in all specialties throughout the growing diversity of practices across the country.
In six articles and a companion editorial, the authors lay the conceptual groundwork for key elements of this effort. The special issue, “Collecting Data on Physicians and Their Practices,” offers insight into both the growing complexity of physician practices and how the features of these practices may be related to variations in the cost and quality of care. The issue also provides guidance on how to link survey data to measures of the decisions made by physicians at the point of care. The articles describe how collecting data on the work of a diverse array of physicians (and other clinicians) and on the practice settings in which they provide care could answer many important questions for the policy, research, and practice communities. As a body of work, the articles not only support the need for a broad national effort to track how physicians respond to a changing policy environment, but they also reveal the challenges associated with structuring such an effort and offer new insight into existing data collection activities.
The JGIM special issue includes the following:
- Making the Case for a New National Data Collection Effort on Physicians and Their Practices
Catherine DesRoches, Herbert Wong, Eugene Rich, and Sumit Majumdar - Factors Contributing to Variations in Physicians' Use of Evidence at the Point of Care: A Conceptual Model
James Reschovsky, Eugene Rich, and Timothy Lake - Measuring Changes in the Economics of Medical Practice
Christopher Fleming, Eugene Rich, Catherine DesRoches, James Reschovsky, and Rachel Kogan - Measuring Comprehensiveness of Primary Care: Challenges and Opportunities
Ann O'Malley and Eugene Rich - Disentangling the Linkage of Primary Care Features to Patient Outcomes: A Review of Current Literature, Data Sources, and Measurement Needs
Ann O'Malley, Eugene Rich, Alyssa Maccarone, Catherine DesRoches, and Robert Reid - Methods of Observing Variations in Physicians' Decisions: The Opportunities of Clinical Vignettes
Lara Converse, Emily Carrier, Kristin Barrett, Eugene Rich, and James Reschovsky - The Results Are Only as Good as the Sample
Catherine DesRoches, Kirsten Barrett, Bonnie Harvey, Rachel Kogan, James D. Reschovsky, Bruce E. Landon, Lawrence P. Casalino, Stephen M. Shortell, and Eugene C. Rich