Why Physicians Don’t Always Follow Best Practices

Jerry Schreibstein, MD, an otolarygologist at Ear, Nose & Throat Surgeons of Western New England in CITY, STATE, who helped develop guidelines on voice improvement after thyroidectomy, said that the difficulty in persuading some patients that guidelines should be followed is a cause for non-adherence “more than we realize.”

“One of the biggest barriers is convincing patients that what you’re doing is appropriate,” he said. “In the case of differentiating an acute URI from sinusitis, it takes more time to educate the patient that they might not need antibiotics, than it does to prescribe the medication. The patient may have the expectation they will get a medication or imaging and when we order antibiotics, a CT scan or a procedure inappropriately, it just reinforces in their mind they have sinus disease.”

In private practice, he said, it helps to have a guidelines “champion” in the office, who stays on top of guidelines and distributes information to the rest of the group. “The Academy tries to disseminate information the best way possible,” he said. “But I think we all know you need to hear things seven times and seven different ways to get a sense of what’s happening.”

Thomas Collins is a freelance medical writer based in Florida.