SALINA, Kan. - Patients often receive inappropriate care when their doctors fail to take into account the patients' unique or individual circumstances, so says a new study performed by the University of Illinois at Chicago and the VA Center for Management of Complex Chronic Care.
The study of physician performance is the largest ever to be conducted using actors presenting as patients in doctors' offices.
Physicians did quite well at following guidelines or standard approaches to care, but not so well at figuring out when those approaches were inappropriate because of a particular patient's situation or life context. Physicians need to understand why a patient is failing, for instance, to control their asthma, rather than just increase the dose of the drugs they prescribe.
Specific issues - such as the lack of health insurance, the need for less costly treatment, or difficulty understanding or following instructions - must be recognized when making clinical decisions. Inattention to such issues leads to what are called "contextual errors" in patient care.