The purpose of this study was to evaluate the use of influential physicians to influencetest ordering in a primary care setting. Structured order forms for three commonly orderedtests were developed in conjunction with the chief residents in internal medicineand family practice at Methodist Hospital of Indiana, a 1120 bed private teachinghospital. After data were collected for a nine month baseline period, the forms wereintroduced by the chief residents to the house staff in the Adult Ambulatory Care Centerand the Family Practice Center. After two months, the study was discontinued. Thedata were analyzed using a multivariate analysis of variance with repeated measuresand paired t-tests. Test ordering rates for complete blood counts were significantlyreduced in both centers. Urinalysis rates were significantly reduced in the FamilyPractice Center. There was no significant effect of the intervention on ordering ratesfor the chemistry-23 test. The findings suggest that the use of influential physicians isan effective way to change physician behavior in primary care settings.

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