Table 3. Survey results: Subgroup analyses by provider type and years in practice.
| Provider type | Years in practice | ||||||
|---|---|---|---|---|---|---|---|
| Question / statement | Physicians N = 178 Mean (SD) |
NP/PA N = 72 Mean (SD) |
P | ≤10 yrs N = 109 Mean (SD) |
11–20 yrs N = 66 Mean (SD) |
>20 yrs N = 69 Mean (SD) |
P |
| Agree / disagree (range 1–6) | |||||||
| Apply latest research findings | 4.4 (1.0) | 4.6 (1.1) | .08 | 4.6 (1.0) | 4.5 (1.0) | 4.2 (1.2) | .12 |
| Responsibility to reduce costs | 5.2 (0.8) | 5.1 (0.8) | .30 | 5.2 (0.8) | 5.3 (0.7) | 5.1 (0.9) | .81 |
| Reducing variation would benefit patientsa | 4.6 (1.0) | 4.4 (1.2) | .68 | 4.6 (1.1) | 4.6 (1.1) | 4.5 (1.2) | .96 |
| Hard to find & understand practice standards | 3.5 (1.3) | 3.3 (1.3) | .26 | 3.7 (1.3) | 3.3 (1.3) | 3.2 (1.2) | .02 |
| Reducing variation would reduce costsa | 4.4 (1.1) | 4.3 (1.1) | .30 | 4.4 (1.0) | 4.4 (1.1) | 4.4 (1.3) | .62 |
| Trust research & systematic reviewsc | 4.1 (0.9) | 4.5 (1.0) | .001 | 4.2 (1.0) | 4.2 (0.9) | 4.1 (0.9) | .74 |
| Depend on practice guidelinesa | 4.8 (0.9) | 5.1 (0.9) | .002 | 5.0 (0.9) | 5.0 (0.8) | 4.6 (0.9) | .004 |
| Easy to apply practice guidelinesd | 4.2 (1.0) | 4.5 (1.0) | .02 | 4.4 (1.0) | 4.3 (1.0) | 4.1 (1.0) | .31 |
| Variation justified by clinical situations | 3.8 (1.2) | 4.2 (1.1) | .03 | 4.1 (1.1) | 4.0 (1.2) | 3.6 (1.2) | .03 |
| Quick to adapt to align with guidelinesa | 4.4 (0.8) | 4.7 (0.9) | .008 | 4.6 (0.9) | 4.4 (0.8) | 4.4 (0.9) | .22 |
| Encourage patients to follow guideline recommendationsc | 4.8 (0.7) | 4.9 (0.8) | .18 | 4.9 (0.7) | 4.8 (0.8) | 4.8 (0.8) | .48 |
| Resist patient requests not grounded in evidence | 4.4 (1.0) | 4.3 (1.2) | .91 | 4.4 (1.0) | 4.3 (1.2) | 4.3 (1.1) | .74 |
| Variation should be reduceda,b | 4.5 (1.1) | 4.6 (0.9) | .64 | 4.5 (1.1) | 4.7 (1.0) | 4.4 (1.1) | .32 |
| Variation can realistically be reducedb | 4.1 (1.0) | 4.0 (0.9) | .44 | 4.1 (0.8) | 4.2 (1.2) | 3.9 (0.9) | .25 |
| How much impact on between-clinician variation? (range 1–4) | |||||||
| Lack access to evidence & guidelinesb | 2.6 (0.8) | 2.8 (0.9) | .12 | 2.6 (0.8) | 2.6 (0.9) | 2.6 (0.9) | .91 |
| Lack awareness evidence & guidelinesb | 2.9 (0.7) | 3.0 (0.7) | .39 | 3.0 (0.7) | 3.1 (0.9) | 2.8 (0.7) | .16 |
| Differences in context & patient populationa,b | 3.0 (0.7) | 3.0 (0.7) | .90 | 3.1 (0.7) | 3.0 (0.6) | 2.9 (0.7) | .53 |
| Differences in clinician experience & trainingb | 3.2 (0.7) | 3.3 (0.6) | .22 | 3.4 (0.6) | 3.1 (0.7) | 3.1 (0.6) | .04 |
| Differences in clinician style & preferencesb | 3.2 (0.7) | 3.3 (0.6) | .75 | 3.2 (0.6) | 3.3 (0.7) | 3.2 (0.7) | .72 |
| Individual patient preferencesb | 2.8 (0.8) | 3.0 (0.8) | .08 | 2.8 (0.8) | 2.9 (0.9) | 2.9 (0.7) | .89 |
| How helpful to standardize your practice? (range 1–4) | |||||||
| Access to guidelines & evidenceb | 2.8 (0.9) | 3.4 (0.8) | < .001 | 3.1 (0.9) | 3.1 (0.9) | 2.7 (1.0) | .11 |
| Time to look up, appraise, & apply standardsb | 3.3 (0.7) | 3.8 (0.5) | < .001 | 3.6 (0.7) | 3.5 (0.7) | 3.1 (0.8) | < .001 |
| Clear institution-wide standard practicesb | 2.9 (0.9) | 3.6 (0.6) | < .001 | 3.3 (0.7) | 3.1 (1.0) | 2.7 (0.9) | .008 |
| Standardized order setsb | 3.0 (0.9) | 3.3 (0.9) | .07 | 3.3 (0.8) | 3.1 (1.0) | 2.9 (0.9) | .12 |
| Decision aids for patient counselingb | 3.1 (0.9) | 3.6 (0.6) | .001 | 3.4 (0.8) | 3.4 (0.8) | 2.9 (0.9) | .005 |
| Feedback comparing my practice with othersa,b | 2.8 (1.0) | 3.3 (0.8) | .009 | 3.0 (0.9) | 3.1 (1.0) | 2.6 (0.9) | .03 |
| Someone else order straightforward testsb | 2.2 (1.1) | 2.3 (1.1) | .62 | 2.2 (1.1) | 2.2 (1.1) | 2.4 (1.0) | .71 |
NP/PA = nurse practitioner / physician assistant, SD = standard deviation, yrs = years. See Table 1 for exact wording and response options for each item. Six respondents did not report time in practice.
a Missing 1 data point (N = item total-1).
b Sample size N = 153 for this item unless otherwise noted by additional footnote; provider type N = 105 physicians, N = 48 NP/PAs; time in practice N = 70 at ≤10 years, N = 39 at 11–20 years, N = 39 at >20 years.
c Missing 2 data points (N = item total-2).
d Missing 3 data points (N = item total-3).