Personal factors as a cause of differences in prescribing by general practitioners.

Joyce, Carole; Last, John M.; Weatherall, M.

doi:10.1136/jech.22.3.170

Cited by 26 publications

(12 citation statements)

References 4 publications

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“…Lynn (1971) found that a physician's attitude about the legitimacy of prescribed drug usage in a variety of settings is more strongly related to the social values and moral standards of the physician than to his medical or scientific background. The physician who is better educated, holds progressive views, considers the patient a whole entity (Joyce, Lost, & Weatherall, 1967), is not authoritarian (Klerman, Sharaf, Holzman, & Levinson, 1969), and finds the patient easy to talk to if not more likeable (Cartwright, 1974) tends not to prescribe mood-modifying drugs. If, on the other hand, the physician is pessimistic about the outcome of treatment or feels anger toward the patient (Shader, Binstock, & Scott, 1968), then mood-modifying drugs are more likely to be prescribed, Brodsky (1 970) reported that physicians also prescribe moodmodifying drugs to housewives in the belief that they can always sleep and need not be mentally alert to perform the job.…”

Section: Physician Behavior and Expectationsmentioning

confidence: 99%

Sex Role Stereotypes and the American Physician

Fidell

1980

Psychology of Women Quarterly

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The potential influence of sex-role stereotypes on women medical patients i s examined in this paper. It is argued that medical practice is, in part, a social enterprise, influenced by sex-role stereotypic notions held by both patients and physicians, and particularly by the interaction of women patients' behavior with physicians' expectations. Indirect evidence suggests that physicians tend to attribute symptoms presented by women to psychogenic rather than organic causes, but that women nonetheless receive more medical treatment than men in the form of unnecessary surgery and psychotropic drugs. The latter is viewed as part of a historical trend that the feminist self-help movement i s attempting to counteract.The American woman makes approximately five visits each year to a physician, usually a general practitioner. Visits average about 1 hour and 20 minutes, including travel and waiting time, so that the typical woman spends about 7 hours a year seeking medical care (HEW Publication, 1972). What i s the quality of that care and the degree of dignity accorded in the manner in which it is delivered? Is the care she receives the same or different from that of a man? How does she behave during the medical interview and how does the physician respond to her behavior? What differences, if any, occur in health treatment as a result of sex-role stereotypes?Evidence for and against the proposition that health care delivery i s affected by sex-role stereotypes is reviewed in this paper. More specifically, the author examines medicine as a social enterprise and reviews historical trends in medical treatment of women, sex-role

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Section: Physician Behavior and Expectationsmentioning

confidence: 99%

Sex Role Stereotypes and the American Physician

Fidell

1980

Psychology of Women Quarterly

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“…A British study showed that doctors qualified overseas were more likely to perceive patients' expectation to prescribe (8) whereas another showed no difference in the volume and cost of drugs prescribed by Asian or British trained physicians (9). Moreover, physicians' postgraduate qualifications or training are associated with lower prescribing rates (8, 10, 11). In a study of British general practitioners, practices providing vocational training prescribed fewer broad‐spectrum antibiotics than the practices not associated with training (12).…”

Section: Introductionmentioning

confidence: 99%

Determinants of physicians' attitude towards prescribing

2002

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“…Thus, it is suspected that all therapeutic interven tions are merely patient oriented. As mentioned by Joyce et al [4] and Hemminki [6], there seems to be an idiosyn cratic element to doctors' prescription habits. Moreover, although side effects are frequently associated with pa tients' non-compliance, there is no evidence for such a prominent role of adverse reactions [7,8].…”

Section: Discussionmentioning

confidence: 99%

“…the possibility of proceed ing in accordance with their own impressions. Although there are quite a few reports on medical prescription pat terns [1][2][3][4], the titration of investigational drugs when compared to placebo as well as concomitant treatment has been widely neglected. Based on experiences in 9 clin ical trials with psychotropic drugs, this paper tries to elu cidate these 'artistic interventions' in order to stimulate some discussion on widely established customs in the design of clinical trials.…”

Section: Introductionmentioning

confidence: 99%

Correct Titration of Non-Drugs and Some Other Methodological Issues

Beneke¹,

Rasmus²,

Rød³

et al. 1994

Neuropsychobiology

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Doctors’ prescription and dosing behaviour was investigated using data from 9 clinical trials in 550 patients treated with psychotropics. 7 trials were conducted under double- and 2 under single-blind conditions. In 3 of these trials, oral and i.m. preparations were used demanding a double-dummy design. All patients were evaluated on a weekly or 2-week basis using psychopathological rating scales (i.e. Hamilton Anxiety Scale, Hamilton Depression Scale, Clinical Global Impressions, Simpson and Angus EPS). It was found that (a) oral-medication titration was 3- to 4-fold more broad-ranging than i.m. medication titration, (b) oral placebo was titrated to the same extent as the oral investiga-tional drugs, and (c) the titration schedule did not follow protocol requirements. Moreover, the average doses in all drug and placebo groups were the same. Concomitant medication like sleep inducers was found to be more closely related to doctors’ habits than to actual medical need. Independent of trial and investigational drug, 10–33% of all patients received additional sleep inducers.

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Personal factors as a cause of differences in prescribing by general practitioners.

Cited by 26 publications

References 4 publications

Sex Role Stereotypes and the American Physician

Sex Role Stereotypes and the American Physician

Determinants of physicians' attitude towards prescribing

Correct Titration of Non-Drugs and Some Other Methodological Issues

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