Explicit training in appropriate decision making about pathology test ordering should be provided early
Developing a training framework that fosters and cultivates a lifetime approach to high value and cost-conscious health care is challenging. High value health care has been defined as “the best care for the patient, with the optimal result for the circumstances, delivered at the right price.”1 In this issue of the MJA, Magin and colleagues report their analysis of the recorded information for almost 115 000 consultations by 876 general practice registrars in Australia.2 During the first 18–24 months of clinical practice, the number of pathology tests they requested increased by 11% per 6-month full-time equivalent term. This significant increase early in clinical practice is worrying; general practitioners request pathology tests more frequently than other medical practitioners,2 and establishing good patterns of decision making in the formative years of clinical training should be a priority.
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 1. Korenstein D. Changing the route to high value care: the role of medical education. JAMA 2015; 314: 2359-2361.
- 2. Magin PJ, Tapley A, Morgan S, et al. Changes in pathology test ordering by early career general practitioners: a longitudinal study. Med J Aust 2017; 207: 70-74.
- 3. Morgan S, Henderson A, Tapley A, et al. Pathology test-ordering behaviour of Australian general practice trainees: a cross sectional analysis. Int J Qual Health Care 2015; 27: 528-535.
- 4. Sirovic B, Lipner R, Johnston M, Holmboe E. The association between residency training and internist’s ability to practice conservatively. JAMA Internal Med 2014; 174: 1640-1648.
- 5. Morgan S, Coleman J. We live in testing times. Teaching rational test ordering in general practice. Aust Fam Physician 2014; 43: 273-276.
- 6. Australian Government, Department of Health. Quality Use of Pathology Program (QUPP) [website]. Updated Mar 2017. http://www.health.gov.au/internet/main/publishing.nsf/Content/pathology-qupp-index (accessed May 2017).
- 7. Gupta R, Arora V. Merging the health system and education solos to better educate future physicians. JAMA 2015; 314: 2349-2350.
- 8. Royal Australian College of General Practitioners. Competency profile of the Australian general practitioner at the point of Fellowship. Dec 2015. http://www.racgp.org.au/download/Documents/Vocational%20training/Competency-profile.pdf (accessed May 2017).
- 9. Chen C, Petterson S, Phillips R, et al. Spending patterns in region of residency training and subsequent expenditures for care provided by practicing physicians for Medicare beneficiaries. JAMA 2015; 312: 2318-2393.
- 10. Stammen L, Stalmeijer R, Paternotte E, et al. Training physicians to provide high-value cost, cost-conscious care: a systematic review. JAMA 2015; 314: 2384-2400.
No relevant disclosures.