There has been extensive documentation of race/ethnicity disparities in treatments received for coronary disease. Moreover, recent evidence suggests that physicians’ perceptions of patients’ social and behavioral characteristics differ by race/ethnicity and socio-economic status of the patient. Although expert guidelines and criteria for appropriateness and necessity of revascularization absolutely omit consideration of patients social and behavioral characteristics, little is known about practicing physicians’ opinions regarding the role of these characteristics in treatment recommendations. Thus, the purpose of this study was to identify the degree to which practicing physicians believe coronary artery disease patients’ social and behavioral characteristics should influence treatment recommendations. Self-administered questionnaires were sent to physicians treating a stratified random sample of patients who had received angiograms in one of 8 randomly selected New York State hospitals. Respondents were asked to provide their opinion on the degree to which patient characteristics (substance abuse, a strong desire for a physically active lifestyle, major responsibilities for the care of family member, social isolation, and significant work demands) should influence a patients’ likelihood for PTCA vs. Medicine, CABG vs medicine and CABG vs PTCA, if all other things were held equal. For each characteristics and treatment choice, the majority of respondents reported believing that the characteristic should influence treatment likelihood. These findings illustrate a significant disconnect between expert panel guidelines and perspectives of practicing physicians. This reinforces the need for explicit discussion of and consensus development regarding the role of social and behavioral characteristics in treatment decisions.
Learning Objectives: Participants will gain insight into the opinions of practicing physicians on the role of patient social and behavioral characterics in clinical decisionmaking
Keywords: Barriers to Care, Access to Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
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Relationship: Not Received.