The Relationship between Physician Characteristics and Prescribing Appropriateness

Primary care physicians in private practice were surveyed in depth to enable evaluation of various structural and sociologic variables as predictors of differential prescribing practices. “Appropriateness” or quality of prescribing behavior was determined by expert judges. While it is often suggested that longer professional experience leads to provision of higher quality medical care, this investigation found more appropriate prescribers to be younger, more recent graduates who have taken additional courses and postgraduate training, but who have had fewer years of experience in practice, maintain larger, hurried practices with more ancillary assistants, and spend less time with each patient. Better prescribes are also found to be more cosmopolitan, modern, and concerned with both psychosocial and quality dimensions of medical care. They frequently consult with (and refer more of their patients to) other physicians and rely most heavily upon journal articles for drug information. Good prescribers are more satisfied with their prior training in therapeutics and more concerned about the current general level of prescribing quality; they seek data on contraindications and are more dissatisfied with existing sources of prescribing information. Finally, the better prcscriber is critical of the pharmaceutical industry and supports an expanded role for the Federal Government in regulating drug quality and costs.