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Medical practice variation: does it cluster within general practitioners practices?

Jong, J. de, Groenewegen, P., Westert, G. Medical practice variation: does it cluster within general practitioners practices? In: G.P. Westert; L. Jabaaij; F.G. Schellevis. Morbidity, performance and quality in primary care: Dutch general practice on stage. Oxon: Radcliffe Publishing, 2006. 125-134
In the ideal situation a patient receives treatment, independent of the general practitioner (GP) or the practice where this GP is working. But this is far from everyday reality. Patients are not alike. GPs are not alike. Practices are not alike. And this leads to sometimes huge variation in medical practice between GPs. Insurance companies, patient organisations, physicians and policy makers are all interested in this phenomenon. We have studied whether visibility of a doctors clinical behaviour and the use of shared resources influence decisions on prescription, referrals, diagnostics, treatment, and advice. We have found that when behaviour is visible to colleagues, or shared resources ar used, GPs working in the same practice behave more alike. The other way around, when behaviour is less visible or no share resources are used, GPs are less inclined to behave in the same way. (aut. ref.)