Horder J, Bosanquet N, Stocking B
J R Coll Gen Pract. 1986 Nov;36(292):517-21.
What evidence is there for the success or failure of the different methods used to influence the behaviour of general practitioners, whether in their work with patients, or in the organization of a practice?This preliminary exploration of the literature suggests that, although change is always occurring, its deliberate inducement is usually slow and laborious. Doubt is cast on the efficacy of existing financial incentives, and of unsolicited feedback about performance. There is little evidence for the influence of audit on behaviour but personal contact with doctors, nurses and other colleagues, and to a lesser extent with patients, is relatively effective, both in influencing the teamwork of a practice and in more formal education. However, it is combinations of different methods which most successfully influence general practitioners.
在影响全科医生行为方面，无论是在他们与患者的工作中，还是在诊所的组织管理方面，所采用的不同方法成败的证据有哪些？对文献的初步探索表明，尽管变化一直在发生，但刻意引发这种变化通常既缓慢又费力。现有经济激励措施以及关于绩效的主动反馈的效果受到质疑。几乎没有证据表明审核对行为有影响，但与医生、护士和其他同事的个人接触，以及在较小程度上与患者的接触，在影响诊所的团队合作以及更正规的教育方面相对有效。然而，最成功影响全科医生的是不同方法的组合。
