title: Practice settings and prescribing profiles: the simulation of tension headaches to general practitioners working in different practice settings in the Montreal area.
abstract: The purpose of this study was to determine whether physicians practicing in one type of setting manage a medical problem differently than those practicing in another type of setting. The investigation took the form of presenting physicians with a simulated case of tension headache with a history going back three years, for which diazepam had been taken daily for the past year. Four simulated patients (aged 20-23) visited a stratified random sample of 111 general practitioners practicing in health centers funded by government (CLSCs) and in private group practice clinics in the Montreal area. Fifty-one per cent of group practice physicians recommended therapy rated as "inadequate" compared to 25 per cent in CLSCs; in addition, the data show significant differences between CLSC and group practice physicians in performing various aspects of the clinical examination. Alternative explanations for the observed differences are discussed.
mesh_terms: D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis; D003151:Community Health Centers; D006123:Group Practice; D006261:Headache / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008962:Models, Theoretical; D010817:Physician-Patient Relations; D010821:Physicians, Family; D011787:Quality of Health Care; D011792:Quebec
chemical_list: D014151:Anti-Anxiety Agents