title: Despite financial penalties, French physicians' knowledge of regulatory practice guidelines is poor.
abstract: OBJECTIVE
  To evaluate the level of awareness and knowledge of regulatory practice guidelines (references medicales opposables [RMOs] or regulatory medical references) implemented to control ambulatory care costs among French family physicians.
  
  
  METHODS
  Observational study. Participants were asked to identify RMO topics among a list of actual and fictitious RMO topics and the RMOs themselves among a list of actual and fictitious RMOs.
  
  
  METHODS
  General practice in France.
  
  
  METHODS
  Three hundred twenty-one family physicians.
  
  
  METHODS
  Average score of 100 (95% confidence interval [CI]) on the awareness of RMO topics and knowledge of the RMOs.
  
  
  RESULTS
  The average overall score was 55.8 of 100 (95% CI, 53.3-58.3) for the awareness of the RMO topics and 50.5 (95% CI, 48.3-52.7) for knowledge of the RMOs themselves-53.2 (95% CI, 51.1-55.3) for diagnostic RMOs and 47.8 (95% CI, 45.6-50.0) for therapeutic RMOs. Chance would have yielded an expected mean score of 50. A statistically significant difference was noted between the average score for actual (62.2) and fictitious (43.2) RMOs, P<.001. None of the respondents correctly identified all 24 correct answers.
  
  
  CONCLUSIONS
  Despite implementation of RMO policy, the awareness and knowledge of RMOs among French family physicians seem weak. The number of RMOs and the difficulties in controlling physicians probably explain these results. Thus, it is doubtful that the RMO policy will have a long-term effect on physicians' behavior.
authors.affiliation: Santé Publique, Faculté de Médecine Broussais Hôtel Dieu, Paris, France. pierre.durieux@egp.ap-hop-paris.fr
authors.forename: P
authors.initials: P
authors.lastname: Durieux
authors.forename: B
authors.initials: B
authors.lastname: Gaillac
authors.forename: B
authors.initials: B
authors.lastname: Giraudeau
authors.forename: M
authors.initials: M
authors.lastname: Doumenc
authors.forename: P
authors.initials: P
authors.lastname: Ravaud
mesh_terms: D002983:Clinical Competence; D005194:Family Practice; D005260:Female; D005602:France; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic