Collins M F, Kneeland M D, Campion F X, Martin P B, D'Andrea J A, Burger P K, Lancey R A, Must A
St. Elizabeth's Medical Center, Boston, MA, USA.
J Healthc Risk Manag. 1997 Spring;17(2):3-11. doi: 10.1002/jhrm.5600170202.
To assess and compare the risk management knowledge of physicians from Massachusetts teaching hospitals.
A survey.
Participating Massachusetts teaching hospitals.
639 of some 2,000 staff physicians of participant hospitals who were sent surveys. An additional 174 postgraduate year 1 (PGY1) and PGY3 house officers also completed the survey.
Percent of questions answered correctly, and comparisons between staff physicians and house officers.
Staff physicians scored higher (87%) than PGY1s and PGY3s combined (81%), P<0.001. Scores among staff physicians did not differ according to field of medicine, age, proportion of time spent in clinical practice, or years in practice. PGY3s did not score significantly higher than PGY1s (82% vs. 80%). Some 40% of physicians said they ordered more tests than necessary because of malpractice worries; they indicated 72% of their colleagues do so as well. Physicians in obstetrics-gynecology and emergency medicine were more likely to respond yes to this question than physicians in other fields of medicine (P<0.001), as were physicians who had been defendants in a malpractice suit (88 P=0.013).
Surveyed staff physicians have an adequate risk management knowledge. Training directors should encourage house officers to attend risk management programs to improve their knowledge. Physicians might overestimate the amount spent on defense medicine based on their perceptions of other physicians.
评估并比较来自马萨诸塞州教学医院的医生的风险管理知识。
一项调查。
参与调查的马萨诸塞州教学医院。
参与调查医院约2000名在职医生中的639人收到了调查问卷。另外174名一年级（PGY1）和三年级（PGY3）住院医师也完成了调查。
正确回答问题的百分比，以及在职医生与住院医师之间的比较。
在职医生的得分（87%）高于PGY1和PGY3的得分总和（81%），P<0.001。在职医生的得分在医学领域、年龄、临床实践时间比例或从业年限方面没有差异。PGY3的得分并不显著高于PGY1（82%对80%）。约40%的医生表示，由于担心医疗事故，他们会开出比必要更多的检查；他们指出，72%的同事也会这样做。妇产科和急诊医学领域的医生比其他医学领域的医生更有可能对这个问题回答“是”（P<0.001），曾在医疗事故诉讼中作为被告的医生也是如此（88，P=0.013）。
接受调查的在职医生具备足够的风险管理知识。培训主任应鼓励住院医师参加风险管理项目以提高他们的知识水平。医生可能会根据他们对其他医生的看法高估用于防御性医疗的费用。
