Changing physician practice behavior to measure and improve clinical outcomes

Richard J. Schuster, Nancy A. Terwoord, Joseph Tasosa

Research output: Contribution to journalArticlepeer-review


Physician practice behavior often produces poor clinical outcomes in the management of cardiovascular disease risk factors in spite of effective treatments and guidelines. The behavior of 165 physicians in 2 settings (suburban and urban) was studied. After collecting baseline clinical data, including systolic blood pressure and low-density lipoprotein cholesterol, a series of interventions was conducted, including academic detailing. Low-density lipoprotein cholesterol decreased 10.4% in suburban patients with cardiovascular disease in the intervention group (P = .001) and 10.5% in the enhanced intervention group (P = .001). Systolic blood pressure decreased 1.11% (P = .357) in the intervention group and 5.13% in the enhanced intervention group (P < .001). In urban hypertensive patients, systolic blood pressure decreased 5.03% (P = .001) and low-density lipoprotein cholesterol decreased 7.01% (P < .001). Combining urban and suburban data, low-density lipoprotein cholesterol decreased 9.32% (P < .001) and systolic blood pressure decreased 4.00% (P < .001). Providing physicians with their clinical outcomes, reviewing national guidelines, and setting expectations, associated with modest practice systems innovations, can produce significant measurable clinical improvements.

Original languageEnglish
Pages (from-to)394-400
Number of pages7
JournalAmerican Journal of Medical Quality
Issue number6
StatePublished - Nov 2006
Externally publishedYes


  • Cardiovascular risk factor reduction
  • Clinical outcomes
  • Metabolic syndrome
  • Physician outcomes
  • Physician practice behavior
  • Systems innovations in practice

ASJC Scopus subject areas

  • Health Policy


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