Embargoed March/April Annals of Family Medicine...( ntenance exams about the quality of the...),Health

ntenance exams about the quality of the decision-making process over three time periods: before, during and after physicians became aware of the lawsuit against the practice. The lawsuit occurred after a family medicine resident and a patient shared the decision about whether the patient would be screened for prostate cancer. The patient, who decided not to be screened, was later diagnosed with prostate cancer and successfully sued the practice. Most patients in the three time periods studied (91 percent, 87 percent and 90 percent respectively) reported having substantial control over the screening decision. Approximately one third described having shared control of the decision with the physician. The authors point out that these findings do not support the premise of defensive medicine whereby the threat or experience of adverse litigation alters clinician behavior.

How Physicians Approach Prostate Cancer Screening Before and After Losing a Lawsuit
By Alex H. Krist, M.D., M.P.H., et al.

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OTHER STUDIES IN THIS ISSUE

DEPRESSIVE SYMPTOMS SEEN IN PRIMARY CARE JUST AS SEVERE AS THOSE SEEN BY PSYCHIATRIC SPECIALISTS

Patients with major depression seen in primary care settings are equally as depressed, with similar symptoms, as those in specialty care, finds this review of data from 2,541 patients. Overall, levels of depressive symptom severity for primary care and specialty care participants were similar, and the authors suggest that these findings indicate a need for aggressive management strategies for depressed patients in both the primary and specialty care settings. Major Depression Symptoms in Primary Care and Psychiatric Care Settings:

A Cross-Sectional Analysis
By Bradley N. Gaynes, M.D., M.P.H., et al.

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GOOD PERFORMANCE IS NOT NECESSARILY GOOD CARE

The author of this essay reflects on how the use of performance measures as one of the means to improve health care
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Contact: Kristin Robinson
kristinr@aafp.org
913-906-6000, ext. 5221
American Academy of Family Physicians
26-Mar-2007

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