TUESDAY, Jan. 21, 2003 (HealthDayNews) -- If it's time for your cat to get shots, your vet will probably send you a reminder in the mail, but new research suggests the same doesn't hold true for humans.
The study found many doctors don't routinely use computers to send medical reminders -- whether it be for mammograms or blood tests -- nor do they take advantage of many other programs that track patients between visits.
Doctors on average have adopted only about five of 16 recommended "care management" approaches. One in six doctors doesn't use any of the programs, which include such things as compiling lists of patients with similar diseases, educating the sick to help themselves, and offering ways for patients to grade their medical care.
"Medicine is still practiced like it was 90 or 100 years ago," says study author Dr. Lawrence Casalino, an assistant professor of health studies at the University of Chicago. "Medical care traditionally has been what your individual doctor can do in 10 to 15 minutes when you happen to show up at his or her office. If you don't come in, nothing happens."
Researchers at the University of Chicago and University of California at Berkeley interviewed top officials at 1,040 medical groups and independent practice associations from 2000-2001. The groups act as intermediaries between insurance companies and doctors.
The officials described how their doctors take care of patients with four chronic diseases -- asthma, congestive heart failure, depression and diabetes. The findings of the survey appear in the Jan. 22 issue of the Journal of the American Medical Association.
According to the survey, 70 percent of doctors don't keep registries of patients with chronic diseases. "If a medical group doesn't know who their diabetics are, it's hard to know if they're getting their blood sugar checked at appropriate intervals and getting flu shots," Casalino says.
The survey also found half the doctors don't use computers to keep track of the medical needs of their patients.
Casalino acknowledges doctors are making progress, but he still finds it "a little odd" that veterinarians do a better job of tracking their patients between appointments than doctors do.
Why are doctors failing to adopt the recommended programs, which have been touted in federal reports? "There's a certain lack of awareness because these things aren't well known yet, and a lot of physicians are skeptical of them," Casalino says.
The medical profession is also behind most other industries in its adoption of medical technology, he adds, pointing out that many doctors still give drug orders by hand, potentially causing many more errors than by ordering them through a computer.
"The industry is behind, but doctors' offices are especially behind," he says. "They have the least capital to invest and the fewest managers around to make these things happen."
In California, change is coming courtesy of a coalition of insurance companies, medical groups, doctors, patients and others. The group, known as the Integrated Healthcare Association, is adopting a system that will provide extra funds for medical groups that adopt recommended approaches to taking care of patients, says executive director Beau Carter.
One problem is the current system doesn't reward groups of doctors "for being the best," Carter says. "We've got our work cut out for us."
More information
To find out more about health plan quality, visit the National Committee for Quality Assurance or the Institute for Healthcare Improvement. For more on the managed-care industry, try the American Association of Health Plans.
