Visit and Physician Characteristics and Low-Value Test Ordering During Unannounced Standardized Patient Visits
| Visit and Physician Characteristics | Total | Low-Value Test Ordered | P Value | |
|---|---|---|---|---|
| No | Yes | |||
| N | 155 | 114 | 41 | |
| Counseling behaviors | ||||
| Normalization | 10 (6.5) | 7 (6.2) | 3 (7.3) | .80 |
| Risks outweigh benefits | 88 (57.1) | 73 (64.6) | 15 (36.6) | .002 |
| Reassurance | 147 (95.5) | 110 (97.3) | 37 (90.2) | .06 |
| Watchful waiting | 104 (67.5) | 99 (87.6) | 5 (12.2) | <.001 |
| Evidence-based strategies | 150 (97.4) | 111 (98.2) | 39 (95.1) | .28 |
| Patient-centeredness (MPCC), mean (SD) | ||||
| Component 1 | 40.7 (7.8) | 40.8 (8.0) | 40.5 (7.4) | .82 |
| Component 2 | 47.5 (16.7) | 47.4 (17.6) | 47.9 (14.0) | .86 |
| Component 3 | 43.1 (13.4) | 42.7 (13.6) | 44.3 (12.8) | .52 |
| Total | 43.8 (8.2) | 43.6 (8.5) | 44.2 (7.4) | .69 |
| Study case | ||||
| Back pain | 55 (35.5) | 40 (35.1) | 15 (36.6) | <.001 |
| DXA | 47 (30.3) | 26 (22.8) | 21 (51.2) | |
| Headache | 53 (34.2) | 48 (42.1) | 5 (12.2) | |
| Intervention Arm | ||||
| Intervention | 78 (50.3) | 58 (50.9) | 20 (48.8) | .82 |
| Control | 77 (49.7) | 56 (49.1) | 21 (51.2) | |
| Physician characteristics | ||||
| Postgraduate year | ||||
| 2 | 85 (54.8) | 60 (52.6) | 25 (61.0) | .62 |
| 3 | 55 (35.5) | 41 (36.0) | 14 (34.1) | |
| 4 | 9 (5.8) | 8 (7.0) | 1 (2.4) | |
| 5 | 6 (3.9) | 5 (4.4) | 1 (2.4) | |
| Stress from uncertainty, mean (SD) | 50.4 (10.8) | 50.2 (10.5) | 50.8 (11.8) | .76 |
| Reluctance to disclose uncertainty, mean (SD) | 25.6 (4.7) | 25.6 (4.7) | 25.8 (4.3) | .79 |
Data are n (%) unless otherwise indicated.
DXA, dual-energy x-ray absorptiometry; MPCC, Measure of Patient-Centered Communication; N, number of encounters (or visits); SD, standard deviation.