What’s the Best Way to Design a Black Barbershop Health Intervention?
Penn LDI Researcher Derek Griffith’s Project Unpacks the Process
Blog Post
Chart of the Day: Information, Relative Skill, and Technology Abandonment
Oncologists’ Reactions to an FDA Warning Discouraging Minimally Invasive Hysterectomies Show Skill Differences Can Prevent the Translation of Evidence into Practice
Print:
While it is widely known that skill levels differ among physicians, it is not known how these skill differences affect their treatment choices. An unexpected safety warning from the U.S. Food and Drug Administration about minimally invasive hysterectomies offered us an opportunity to evaluate how a negative information shock affects clinical practice across physicians with different skill levels.
My colleague Bingxiao Wu and I evaluated data from patients who received either minimally invasive or open hysterectomies between January 2012 and September 2015 in Florida. We found that after the FDA issued a safety warning in April 2014, discouraging the use of laparoscopic power morcellation during minimally invasive hysterectomies due to evidence that it could spread undetected malignant tissue, oncologists shifted toward performing open procedures and away from the minimally invasive procedures. However, as the above chart shows, oncologists who were more skilled in performing minimally invasive procedures were far less likely to abandon this procedure compared to those who were less skilled in these procedures.
The results speak directly to policies that aim to integrate evidence-based medicine with individual practice. They demonstrate that differences in physician skill can be a key barrier to translating evidence into practice. Policies that ignore these differences may lead to negative consequences, including medical complications and, in rare cases, death.
The study, Information, Relative Skill, and Technology Abandonment, was published in the Journal of Health Economics in May 2022. Authors include Bingxiao Wu and Guy David.
Author
Guy David, PhD
Allen B. Miller Professor, Health Care Management, Wharton School; Professor, Health Policy and Medical Ethics, Perelman School of Medicine; Chair, Health Care Management, Wharton School
More from LDI
Experiences of Patients With Disabilities Can Inform How to Improve Care
Patients Perceive Gaps in Communication and Disrespect During Health Care Visits According to a National Survey
Medicaid’s Role in Health and in the Health Care Landscape
LDI Expert Insights and Key Takeaways from Select Publications
AI Scribes: Can Technology Do More Than Free Doctors From Data Entry?
A Penn Lab Takes a New Approach to Unpacking the Doctor-Patient Encounter
Chart of the Day: Health Care Profits Increasingly Support Shareholder Payouts
$2.6 Trillion From Publicly Traded Companies Went to Dividends and Stock Buybacks, LDI Study Shows
How Corporatization Continues to Change U.S. Health Care
Penn LDI Virtual Seminar Featured Top Experts Analyzing the Issues
Research Brief: Medicare Advantage Special Needs Plans Linked to Use of Inferior Hospice Care
People Dually Eligible for Medicare and Medicaid are More Likely to Get Care From Poorer Quality Hospices
First-Of-Its-Kind Trial Shows Promise of Coordinating Child Asthma Care Across a City
Community Health Workers Link Care In Homes, Schools, and Clinics in Philadelphia