Physician Behavior Research Articles

Perceptions and Behaviors of Nurses and Physicians During Bedside Rounds in Medical-Surgical Units.

Communication and collaboration among health care professionals during bedside rounds improve patient outcomes and nurses' and physicians' satisfaction. To determine barriers to nurse-physician communication during bedside rounds and identify opportunities to improve nurse-physician collaboration at an academic medical center. A survey with Likert-scale and open-ended questions regarding professional attitudes toward nurse-physician communication was administered to 220 nurses and physicians in medical-surgical units to assess perceptions of participation in bedside rounds. After the survey was given, observational data from 1007 bedside rounds were collected via a standardized data collection tool. Nurses and physicians perceived different barriers to including nurses in bedside rounds. Nurses most often cited being unaware that bedside rounds were occurring (38 of 46 nurses [83%]); physicians most often cited nurse unavailability (43 of 52 physicians [83%]). Of 1007 observed rounds, 602 (60%) involved in-person contact of nurses and physicians; 418 (69%) of the 602 included a conversation between the nurse and physician about the nurse's concerns. Of 355 rounds with no in-person or telephone contact between nurses and physicians, the medicine team did not contact the nurse in 284 (80%). Conversations about nurses' concerns occurred more often after physician-initiated contacts (73% of 369 contacts) and nurse-initiated contacts (74% of 93 contacts) than after chance encounters (57% of 140 contacts). Initiating discussions of care between nurses and physicians and discussing nurses' concerns during bedside rounds have multiple benefits.

Counterproductive Behaviors in the Healthcare Setting: History and Recommended Approaches for Addressing Disruptive Physician Behaviors

Healthcare is a complex multidimensional delivery system that depends on effective communication and collaboration between all health team members. The goal is to provide safe, high-quality, appropriate, and effective care that results in the best possible patient outcomes. When individuals act in an unprofessional, inappropriate, counterproductive manner, it can negatively affect team focus and concentration that can impair healthcare relationships which can affect roles, responsibilities, and task completion, all of which may lead to the occurrence of adverse medical events that can hurt patient safety and quality of care. In the healthcare setting, this counterproductive work behavior often is categorized as disruptive behavior, and it can cause a toxic medical environment that prevents individuals from doing their jobs. Gaining a better understanding of these types of behaviors, their causes, and their consequences will help raise awareness and lead to the development of policies and procedures that can address these issues and prevent emotional and physical harm to both staff and patient. Early recognition and early intervention can reduce the likelihood and impact of disruptive events.

An examination of the vacation behaviors of United States emergency physicians.

An examination of the vacation behaviors of United States emergency physicians.

Practices and Trends in the Prescription of Probiotics: A Detailed Analysis in an Eastern European Region

The lack of clear prescribing protocols in the field of probiotics creates difficulties for physicians in the uniform application of these adjuvant therapies. Although there are guidelines that evaluate existing studies and provide different levels of evidence for the efficacy of probiotics, they do not offer specific prescribing strategies. The present study explores how this gap influences the prescribing behavior of physicians, analyzing the diagnoses associated with prescribed probiotics, the duration of treatment, and the associations with antibiotics. Additionally, the study addresses potential omissions in prescribing strategies, exploring discrepancies and possible errors in doctors’ recommendations. Through this research, an attempt is made to understand correctly how probiotics are integrated into treatment protocols, with the aim of improving prescribing directions and effective use in the future.

Eye tracking insights into physician behaviour with safe and unsafe explainable AI recommendations

We studied clinical AI-supported decision-making as an example of a high-stakes setting in which explainable AI (XAI) has been proposed as useful (by theoretically providing physicians with context for the AI suggestion and thereby helping them to reject unsafe AI recommendations). Here, we used objective neurobehavioural measures (eye-tracking) to see how physicians respond to XAI with N = 19 ICU physicians in a hospital’s clinical simulation suite. Prescription decisions were made both pre- and post-reveal of either a safe or unsafe AI recommendation and four different types of simultaneously presented XAI. We used overt visual attention as a marker for where physician mental attention was directed during the simulations. Unsafe AI recommendations attracted significantly greater attention than safe AI recommendations. However, there was no appreciably higher level of attention placed onto any of the four types of explanation during unsafe AI scenarios (i.e. XAI did not appear to ‘rescue’ decision-makers). Furthermore, self-reported usefulness of explanations by physicians did not correlate with the level of attention they devoted to the explanations reinforcing the notion that using self-reports alone to evaluate XAI tools misses key aspects of the interaction behaviour between human and machine.

Effects of anti-corruption campaigns on cesarean section rate: evidence from China

The excessive utilization of cesarean section (CS) has become a global concern, given the potential short-term and long-term detrimental effects for mothers and infants. Worldwide, the rate of CS continues to rise, but efforts to curtail unnecessary CS procedures have yielded limited success. By combining data from three resources, this study aims to estimate the effects of anti-corruption campaigns under the Xi administration on CS rates. We focus on Shanxi Province, a major coal-producing province in north-central China, with notoriety for the collusion between local politicians and business elites. Using the data from the China Corruption Investigation Dataset and data from publicly listed firms between 2013 and 2016, we found that anti-corruption campaigns significantly changed the social environment as firms’ business entertainment spending experienced substantial reductions. Using discharge records from 137 public hospitals, we adopted an instrumental variable (IV) approach and found that the anti-corruption campaigns led to significant reductions in unnecessary CS rates. The reductions are bigger among patients with second or later deliveries. We also find that the anti-corruption campaigns changed behaviors of attending and resident physicians. Our results provide insights into strategies to reduce corrupt practices within the healthcare sector and implementing interventions to minimize the occurrence of CS among healthy women and newborns.

Revealing the synergetic influence of pharmaceutical marketing strategies on physician prescription patterns: a moderated mediation investigation

PurposeThis study aims to investigate the combined impact of pharmaceutical marketing strategies, specifically free drug samples and interactions with medical representatives, on physicians’ attitudes and prescribing behavior in Jammu and Kashmir, India.Design/methodology/approachTo achieve this objective, data were collected from a sample comprising 425 physicians. A six-point forced-choice Likert scale was used for data collection, and cluster sampling techniques were used in the study design.FindingsThe study reveals significant insights into pharmaceutical marketing’s influence on physician behavior. Free drug samples exert a positive influence on both physician attitudes and prescribing behavior. Physicians’ attitudes, in turn, significantly affect their prescribing decisions. Mediation analysis demonstrates that free drug samples indirectly influence prescribing behavior through shifts in physician attitudes. Effective medical representatives amplify this influence, as stronger associations between free drug samples and physician attitudes are observed when representatives are more effective.Originality/valueThis research contributes by unraveling the intricate dynamics between marketing strategies, physician attitudes and prescribing behavior in Jammu and Kashmir, India. It underscores the importance of ethical pharmaceutical marketing practices, highlighting the substantial role of free drug samples and the crucial function of effective medical representatives in shaping physician behavior. Ultimately, this study sheds light on how responsible pharmaceutical marketing and adept medical representatives can improve health-care outcomes in the region.

Impact of group work on the hidden curriculum that induces students’ unprofessional behavior toward faculty

BackgroundHidden curriculum (HC) can limit the effects of professionalism education. However, the research on how HC triggers unprofessional behavior among medical students is scant. Furthermore, there is no established approach for how faculty members may create a context, such as an educational environment and education system, that prevents students’ unprofessional behavior. This study aimed to develop an educational approach to prevent unprofessional behavior and clarify how faculty members consider HC that triggers students’ unprofessional behavior.MethodsThe study sample comprised 44 faculty members and eight medical students from the Chiba University School of Medicine. The participants were divided into groups and asked the following question: “What attitudes, statements, and behaviors of senior students, physicians, and faculty members trigger medical students’ unprofessional behavior?” The responses were collected using the affinity diagram method. The group members discussed the causes and countermeasures for the selected attitudes, statements, and behaviors of senior students, physicians, and faculty members based on the affinity diagram. The impact of the group work on the faculty members was surveyed using questionnaires immediately after its completion and six months later. Furthermore, the cards in the group work were analyzed using content analysis.ResultsThe responses to the questionnaire on group work indicated that some faculty members (43.8%) improved HC, while others suggested conducting group work with more participants. The content analysis revealed six categories – inappropriate attitude/behavior, behavior encouraging unprofessional behavior, lack of compliance with regulations, harassment of other medical staff, inappropriate educational environment/supervisor, and inappropriate self-control – and 46 subcategories.ConclusionsThe HC that triggers students’ unprofessional behavior includes the words and actions of the educator, organizational culture, and educational environment. Group work makes faculty members aware of the HC that triggers unprofessional behavior, and induces behavioral change for HC improvement in the educational activities. Educators should refrain from using words and actions that encourage unprofessional behavior, such as personal anecdotes, as they reduce students’ learning motivation.

Improvement of human performance in healthcare systems by taking into account physician behavior

PurposeEfficiency standards, similar to industrial measures like overall equipment effectiveness (OEE), are being used in healthcare systems more and more. Performance indicator models applied to machines assume a constant completion time. However, for human resources, the completion time of a task may vary depending on the stress experienced. This study seeks to bridge this gap by integrating the human behavior of the physician into the performance evaluation.Design/methodology/approachThe paper presents a new algorithm called PerfoBalance that is intended to distribute waiting-patient values among doctors. By maximizing each physician’s stress zones, this method helps to improve their performance as a whole. A thorough case study with medical professionals is carried out to confirm the effectiveness of the suggested methodology. The PerfoBalance algorithm is used in a variety of contexts to divide waiting-patient values among doctors and optimize stress zones.FindingsExperimental results demonstrate a significant improvement in physician efficiency when implementing the PerfoBalance algorithm. The algorithm strategically selects stress zones that contribute to higher performance rates for physicians by optimizing waiting-patient values.Originality/valueBy addressing the undervaluation of human performance difficulties in current efficiency models used in the healthcare industry, this research constitutes a significant contribution to the field. With its launch, the PerfoBalance algorithm offers a fresh viewpoint on waiting-patient value allocation and stress zone management in healthcare settings, hence representing a powerful method for increasing physician productivity.

Comparison of Physicians' Attitudes and Practice Regarding Vaccination during Pregnancy in Turkey.

This study aimed to investigate the knowledge, attitudes, and behaviors of family physicians (FPs), pediatricians (PPs), and obstetricians and gynecologists (OGs) regarding vaccine administration during pregnancy in Turkey as factors that contribute to decision-making. The survey was distributed among FPs, OGs, and PPs, and participants were asked to rate their knowledge on specific topics using a five-point scale ranging from "Not Effective" to "Effective". The tetanus and diphtheria (Td) vaccine was highly recommended by 94.9% of physicians and considered very effective. Among the physicians surveyed, 80% of PPs and 66.0% of OGs were aware of the disease burden of pertussis. We also found that 74.5% of FPs and 77.2% of PPs believed they needed more information about vaccination during pregnancy. All physicians surveyed agreed or strongly agreed that explaining the disease risks and benefits of vaccination increases the vaccine acceptance rate. The results of this survey study indicate that the knowledge and awareness of physicians need to be improved to increase vaccination rates during pregnancy in Turkey, and it is essential to incorporate influenza and tetanus, diphtheria, and pertussis (TdaP) vaccines into the standard maternal immunization schedule for newborns.

Valuing Outpatients' Perspective on Primary Health Care Services in Greece: A Cross-Sectional Survey on Satisfaction and Personal-Centered Care.

The aims of the study were to identify and analyze the determinants associated with outpatient satisfaction in Greek primary care. This is because there is a general consensus that primary care is the linchpin of effective person-centered care delivery. A cross-sectional survey was conducted with 1012 patients' exit interviews; sociodemographic variables were included in the questionnaire to obtain data on the satisfaction of primary care users with 20 public primary healthcare centers in Athens between June 2019 and April 2021. Statistical analysis was applied to 55 items and eight dimensions of patient satisfaction, namely, arrival and admission, waiting before the appointment, cleanliness of toilets, medical examination and behavior of physician, behavior of nursing staff, laboratories, departure, and contribution of the PHCs. Descriptive analyses and multiple linear regression were used to analyze the factors influencing patient satisfaction through coefficients (β) with 95% confidence intervals and associated tests of statistical significance. Τwo-thirds (74.21%) of this survey's participants ranged from 45 to 74 years of age. More than half of the participants were women (62.15%). The most common reasons for visits were pathological (26.48%), followed by cardiological conditions (9.78%), orthopedics (9.49%), gynecologic conditions (8.70%), and ophthalmologic problems (7.31%). In the center of satisfaction with primary care was the medical care and the behavior of the physician (β = 0.427; p < 0.01), followed by the time during appointment (β = 0.390; p < 0.01). Dimensions like "accessibility and availability, 2.19/5"; "waiting times, 2.89/5"; "infrastructure of facilities (2.04/5) and cleanliness of them, (2/5)"; "laboratories, 2.99/5" and "bureaucracy in the departure, 2.29/5" were crucial for the trust and satisfaction of patients. Overall satisfaction was rated at a moderate level (2.62 ± 0.18) while person-centered care was rated as weak (2.49 ± 0.28). Greece is recommended to increase the sensitivity of the use of the primary health care system by patients as a first contact, continuous, comprehensive, and effective patient- and family-focused care.

The Effect of Adverse Events on Orthopaedic Surgeons: A Review.

The purpose of this review was to evaluate the effect of adverse events (AEs) on orthopaedic surgeons, illustrate common ways orthopaedic surgeons deal with AEs, and describe solutions to reduce the negative effect of AEs and prevent them from recurring. AEs are common in orthopaedic surgery and increase the risk of depression, anxiety, and suicide. Orthopaedic surgeons may experience negative effects after AEs even when they are not at fault. AEs are linked to moral injury, second victim syndrome, burnout, and disruptive physician behaviors. Many surgeons deal with AEs in isolation out of fear of a negative effect on their professional reputation, potentially leading to increased psychological distress and unhealthy coping mechanisms. Healthy ways to address AEs and improve the well-being of surgeons include destigmatizing psychological stress after AEs and creating a culture of receptivity and peer support.

“Not me!” a qualitative, vignette-based study of nurses’ and physicians’ reactions to spiritual distress on neuro-oncological units

PurposePeople with primary malignant brain tumors experience serious health-related suffering caused by limited prognosis and high symptom burden. Consequently, neuro-oncological healthcare workers can be affected emotionally in a negative way. The aim of this study was to analyze the attitudes and behavior of nurses and physicians when confronted with spiritual distress in these patients.MethodsNeurospirit-DE is a qualitative vignette–based, multicenter, cross-sectional online survey that was conducted in Bavaria, Germany. Reflexive thematic analysis was used for data analysis.ResultsA total of 143 nurses and physicians working in neurological and neurosurgical wards in 46 hospitals participated in the survey. The participants questioned if the ability to provide spiritual care can be learned or is a natural skill. Spiritual care as a responsibility of the whole team was highlighted, and the staff reflected on the appropriate way of involving spiritual care experts. The main limitations to spiritual care were a lack of time and not viewing spiritual engagement as part of the professional role. Some were able to personally benefit from spiritual conversations with patients, but many participants criticized the perceived emotional burden while expressing the imminent need for specific training and team reflection.ConclusionsMost neuro-oncological nurses and physicians perceive spiritual care as part of their duty and know how to alleviate the patient’s spiritual distress. Nonetheless, validation of spiritual assessment tools for neuro-oncology and standardized documentation of patients’ distress, shared interprofessional training, and reflection on the professional and personal challenges faced when confronted with spiritual care in neuro-oncology require further improvement and training.

Knowledge, Attitudes, and Behaviors of Family Physicians Towards Hyperbaric Oxygen Therapy

In our study, we aimed to investigate the knowledge, attitude, and behavior of physicians toward hyperbaric oxygen therapy (HBOT). Our study is a cross-sectional study. We included a total of 251 physicians, consisting of Family Medical Specialists, residents of Family Medicine Residency program, contracted residents of Family Medicine Residency program (residents who work actively in primary health units and matched with Family Medicine residency program) and General Practitioners (non-specialized family physicians) working in Ankara, between the dates 01.04.2021 and 26.11.2021. A questionnaire consisting of a total of 51 questions was given to the participants on the internet in order to determine the level of knowledge, attitude and behavior towards HBOT. 251 people, 162 women and 89 men, participated in the study. Of the participants in the study, 137 were residents of the Family Medicine residency program, 57 General practitioners, and 57 Family Medical Specialists. It was observed that 60.2% of the physicians responded with a “no” to the question, “Do you know the indications of HBOT?”. 55% of the physicians did not know about the cost of HBOT therapy. The rate of knowledge of the indication of carbon monoxide poisoning was significantly higher among the physicians who had an HBOT center in their institution (p&lt;0.05). It was observed that 98% of the participants did not know the treatment pressure applied during HBOT, and 97.2% did not know the technique of oxygen administration. While investigating the knowledge, attitudes, and behaviors towards HBOT, we observed that our physicians had some deficiencies, even though they had partial knowledge about it. In our study, we saw that our physicians are aware of their lack of knowledge about HBOT and are open to training on this subject. We think that in order to eliminate this deficiency, a course related to this field can be added to either university curricula or specialist training curricula.

Patient’s Perception and Satisfaction with Healthcare Professionals at Primary Health Care Facilities in Onelga (Ogba Egbema Ndoni LGA)

Background: This study investigates the patient's perspective and contentment with healthcare professionals at primary health care facilities in Onelga (Ogba Egbema Ndoni LGA). Employing a survey research design, data was collected from 100 healthcare professionals using a structured questionnaire. The study's objectives include assessing patient satisfaction with healthcare services, exploring the correlation between physician behavior and healthcare services, and determining factors influencing satisfaction levels in the study area. Methods: Demographic data analysis reveals the majority of respondents are male, aged above 60, with educational backgrounds ranging from FSLC to MSC/PGD/PHD. Results: Patient satisfaction findings indicate a significant proportion agreeing or strongly agreeing with positive sentiments regarding healthcare services, physician behavior, and facility cleanliness. Additionally, statistical tests affirm a significant relationship between healthcare services and patient satisfaction. The study concludes that patient satisfaction is influenced by efficient service delivery, physician behavior, and facility infrastructure. Conclusion: Recommendations include regular assessment of patient satisfaction, enhancing healthcare service efficiency, and addressing factors influencing patient contentment. This research contributes to the broader understanding of patient perspectives in healthcare settings, facilitating improvements in service quality and overall patient experience

Physician behavior: Experimental evidence from physician and patient perspectives

Physician motives remain a hotly debated and sensitive topic. Given the sensitive nature of this issue, direct questions may elicit either dishonest responses or no response at all. To mitigate this risk, we carried out two list experiments between November 2022 and February 2023 to examine two important physician behaviors from both the physician and patient perspectives. In these experiments, participants in the control and treatment groups were shown a list of non-sensitive statements. Additionally, each treatment group received a sensitive statement related to either demand inducement or demand enablement behavior. Participants were then asked to report only the number of statements with which they agreed. The difference in the mean number of statements agreed upon between the control and treatment groups revealed the prevalence rates of sensitive behaviors. In the physician experiment, we observed a 25 % prevalence rate (standard error (SE) = 0.127, p = 0.046) for demand inducement behavior and a 65 % rate (SE = 0.125, p < 0.001) for demand enablement behavior. In the patient experiment, compared to the control group, 52 % of participants (SE = 0.074, p < 0.001) perceived that physicians exhibit demand inducement behavior, while 39 % (SE = 0.073, p < 0.001) demonstrated behavior consistent with demand enablement. These findings indicate that physicians are more prone to offer unnecessary medical services when patients actively participate, underscoring the significant influence of patients on physician behavior.

Comparative analysis of positive thinking and stress levels in physicians and medical staff

The article compares the features of positive thinking and stress levels in physicians and medical staff, but the nature of duties and work differs in many ways, which may serve to identify significant differences among workers of two similar professions. The purpose of the study is to examine the positive thinking and stress levels characteristics in helping professions. Objectives of the study are to analyze the scientific literature, to identify the positive thinking and stress levels in specialists, and to establish differences in these levels in specialists of different profiles. The subject of the study is the peculiarities of positive thinking and stress levels in specialists. The literature on the topic under study has been analyzed according to the works of N.E. Vodopyanova, T.O. Gordeeva, E.N. Osin, V.Y. Shevyakhova, and Yu.V. Scherbatykh. The following methods were used: stress manifestations complex assessment (Yu.V. Shcherbatykh (2008), questionnaire of successes and failures reaction ways for adults (STONE-V, T.O. Gordeeva, V.Y. Shevyakhova (2008), optimism and activity scale in N.E. Vodopyanova’s adaptation (2009). Statistically significant differences have been revealed only on the “Optimism in the situation of success” scale, which indicates the difference in the behavior of physicians and medical staff. The results of the study can be the basis for creating recommendations for helping employees cope with stress. The prospect is to extend the study of the phenomenon to other helping professions and compare the results.

Fitting in? Physician practice style after forced relocation.

This study aims to examine how variation in physicians' treatment decisions for newborn deliveries responds to changes in the hospital-level norms for obstetric clinical decision-making. All hospital-based births in Florida from 2003 through 2017. Difference-in-differences approach is adopted that leverages obstetric unit closures as the source of identifying variation to exogenously shift obstetricians to a new, nearby hospital with different propensities to approach newborn deliveries less intensively. Births attributed to physicians continuously observed 2 years before the closure event and 2 years after the closure event (treatment group physicians) or for identical time periods around a randomly assigned placebo closure date (control group physicians). All of the physicians meeting our inclusion criteria shifted their births to a new hospital less than 20 miles from the hospital shuttering its obstetric unit. The new hospitals approached newborn births more conservatively, and treatment group physicians sharply became less aggressive in their newborn birth clinical management (e.g., use of C-section). The immediate 11-percentage point (33%) increase in delivering newborns without any procedure behavior change is statistically significant (p value <0.01) and persistent after the closure event; however, the physicians' payer and patient mix are unchanged. Obstetric physician behavior change appears highly malleable and sensitive to the practice patterns of other physicians delivering newborns at the same hospital. Incentives and policies that encourage more appropriate clinical care norms hospital-wide could sharply improve physician treatment decisions, with benefits for maternal and infant outcomes.

HSD126 Diagnosing Rare Diseases: Referral Behaviors of Physicians in the United States

HSD126 Diagnosing Rare Diseases: Referral Behaviors of Physicians in the United States

The impact of implicit bias and emotional intelligence on physician attitudes and behaviors

The impact of implicit bias and emotional intelligence on physician attitudes and behaviors