I don’t mean to profile physicians like they are criminals as in Criminal Minds, the TV crime drama. But that’s indeed where I got my idea from. It turns out that profiling physician is not a new concept. Managed care in US has been using physician profiling to make sense of the prescription data and to develop strategies for cost containment. The pharma companies have also developed sophisticated tools to analyze physicians’ behaviour and prescribing patterns to understand how to target them more effectively.
So I thought, wouldn’t it be nice we have profiles of all the physicians we have to work with. They can help me understand how to tailor my support and collaborate with them. So here are my top three areas I like to profile my physicians on:
Practice Setting and Logistics
Is the physician part of a family health team or runs his solo practice? What are the hours of operations? Does the physician has any special interest or practice philosophy? What resources do they have already? When is the best time to meet with the physician for academic detailing? This basic information sets the stage to determine how to collaborate.
Common Medications by Therapeutic Class
You can learn a lot about the physician from looking at his or her commonly prescribed medications. This information may reflect current practice setting (e.g. family medicine, respirology, pediatrics), whether the physician is conservative or like to embrace new therapies, and may offer some indication whether antibiotics are overly prescribed.
Quality of the Prescription Order
This domain includes details related to the prescription order – everything that pharmacists have to endure daily. This ranges from looking at the legibility of the prescription, the indication (or lack of), the dosing accuracy and a general awareness of contraindications and side effects. By auditing a handful of prescription orders and assigning a score based on this domain, one can quantify the quality of the prescription orders. A physician with a high score is likely to write legibly, provides indication for each prescription and rarely needs clarification from the pharmacist – one who has my utmost respect! One with a low score, well …..may indicate a need for further investigation or education.
By analyzing the data, we may discover a more effective way to collaborate with each physician. Instead of reacting to a dose that is way too high for a patient, we can proactively identify the top ten medications commonly prescribed by the physician and provide a cheat sheet on how to adjust dose for renal impairment and other clinical considerations. Instead of faxing physicians with endless notifications of drug interactions that may not be relevant, we can start a conversation on how to best manage these drug interactions more efficiently and proactively.
So here’s my humble plan for physician profiling. I wonder if such a concept is a waste of time. After all, who has the resources to set up and maintain these profiles? On the other hand, we DO have all the prescription data at our disposal; we may discover something interesting by analyzing them?
Should I test out this novel idea? Maybe my next step is to recruit a keen pharmacy student.
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