Analysis of questions asked by family doctors regarding patient care
BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7206.358 (Published 07 August 1999) Cite this as: BMJ 1999;319:358
- John W Ely, associate professor (john-ely{at}uiowa.edu)a,
- Jerome A Osheroff, deputy editor, integrated clinical information resourcesb,
- Mark H Ebell, associate professorc,
- George R Bergus, associate professora,
- Barcey T Levy, associate professora,
- M Lee Chambliss, clinical assistant professord,
- Eric R Evans, staff physiciane
- a Department of Family Medicine, University of Iowa College of Medicine, 200 Hawkins Drive, 01291-D PFP, Iowa City, IA 52242, USA
- b American College of Physicians- American Society of Internal Medicine, Philadelphia, PA, USA
- c Department of Family Practice, Michigan State University, East Lansing, MI, USA
- d Moses Cone Hospital Family Medicine Residency, Greensboro, NC, USA
- e Student Health Service, University of Iowa, Iowa City
- Correspondence to: J W Ely
- Accepted 29 June 1999
Abstract
Objectives: To characterise the information needs of family doctors by collecting the questions they asked about patient care during consultations and to classify these in ways that would be useful to developers of knowledge bases.
Design: Observational study in which investigators visited doctors for two half days and collected their questions. Taxonomies were developed to characterise the clinical topic and generic type of information sought for each question.
Setting: Eastern Iowa.
Participants: Random sample of 103 family doctors.
Main outcome measures: Number of questions posed, pursued, and answered; topic and generic type of information sought for each question; time spent pursuing answers; information resources used.
Results: Participants asked a total of 1101 questions. Questions about drug prescribing, obstetrics and gynaecology, and adult infectious disease were most common and comprised 36% of all questions. The taxonomy of generic questions included 69 categories; the three most common types, comprising 24% of all questions, were “What is the cause of symptom X?” “What is the dose of drug X?” and “How should I manage disease or finding X?” Answers to most questions (702, 64%) were not immediately pursued, but, of those pursued, most (318, 80%) were answered Doctors spent an average of less than 2 minutes pursuing an answer, and they used readily available print and human resources Only two questions led to a formal literature search.
Conclusions: Family doctors in this study did not pursue answers to most of their questions. Questions about patient care can be organised into a limited number of generic types, which could help guide the efforts of knowledge base developers.
Key messages
Questions that doctors have about the care of their patients could help guide the content of medical information sources and medical training
In this study of US family doctors, participants frequently had questions about patient care but did not pursue answers to most questions (64%)
On average, participants spent less than 2 minutes seeking an answer to a question
The most common resources used to answer questions included textbooks and colleagues; formal literature searches were rarely performed
The most common generic questions were “What is the cause of symptom X?” “What is the dose of drug X?” and “How should I manage disease or finding X?”
Footnotes
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Funding This study was supported by a grant (G9518) from the American Academy of Family Physicians Foundation.
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Competing interests None declared.
- Accepted 29 June 1999