title: Open questions concerning influences on clinical decision making.
abstract: Efforts to influence utilization of services to bring down spending and to improve quality of care have largely failed. A critical reason is that most attention has focused on dysfunctional financial incentives without considering other factors that also influence physicians' utilization decisions. In this article, after providing a framework for ideal physician-patient interactions, questions are also raised about other influences, including physicians' impulse to help patients, professional codes of ethics, the threat of malpractice claims, and the leadership of health care organizations. An Appendix contains a summary of the literature on these factors.
authors: Boston University School of Management, Boston, MA 02215, USA. sdavidso@bu.edu
authors: Stephen M
authors: SM
authors: Davidson
mesh_terms: D003657:Decision Making; D004992:Ethics, Medical; D005102:Health Expenditures; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D010817:Physician-Patient Relations; D058996:Quality Improvement; D011787:Quality of Health Care; D014481:United States