title: Physician styles of patient management as a potential source of disparities: cluster analysis from a factorial experiment.
abstract: OBJECTIVE
  To identify styles of physician decision making (as opposed to singular clinical actions) and to analyze their association with variations in the management of a vignette presentation of coronary heart disease (CHD).
  
  
  METHODS
  Primary data were collected from primary care physicians in North and South Carolina.
  
  
  METHODS
  In a balanced factorial experimental design, primary care physicians viewed one of 16 (2(4)) video vignette presentations of CHD and provided detailed information about how they would manage the case.
  
  
  METHODS
  256 MD primary care physicians were interviewed face-to-face in North and South Carolina.
  
  
  RESULTS
  We identify three clusters depicting unique styles of CHD management that are robust to controls for physician (gender and level of experience) and patient characteristics (age, gender, socioeconomic status, and race) as well as key organizational features of physicians' work settings. Physicians in Cluster 1 "Cardiac" (N = 92) were more likely to focus on cardiac issues compared with their counterparts; physicians in Cluster 2 "Talkers" (N = 93) were more likely to give advice and take additional medical history; whereas physicians in Cluster 3 "Minimalists" (N = 71) were less likely than their counterparts to take action on any of the types of management behavior.
  
  
  CONCLUSIONS
  Variations in styles of decision making, which encompass multiple outcome variables and extend beyond individual-level demographic predictors, may add to our understanding of disparities in health quality and outcomes.
authors.affiliation: Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, CO 80217-3364, USA.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Lutfey
authors.forename: Eric
authors.initials: E
authors.lastname: Gerstenberger
authors.forename: John B
authors.initials: JB
authors.lastname: McKinlay
mesh_terms: D002317:Cardiovascular Agents; D016000:Cluster Analysis; D003142:Communication; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000628:therapy*; D003657:Decision Making; D015438:Health Behavior; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008019:Life Style; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012307:Risk Factors; D014481:United States; D014743:Videotape Recording
chemical_list: D002317:Cardiovascular Agents