What Influences Physician Behavior?

As many reported today, the United States Preventative Services Task Force recommended against the use of the PSA screening test for prostate cancer. It was previously recommended against in men 75 or older. But now, the recommendation extends to all ages.

Which begs the question: Will this guideline influence physician behavior? Will physicians actually avoid ordering this test? In the past, many inside and outside of medicine have said that physicians listen to data and evidence. You see, the data on PSA testing has been known for YEARS, but physicians kept ordering the test.

Well, some say this: "Well, physicians will listen to other physicians. We just need to get their professional organizations to get on board. It's a peer to peer communication thing." That was the point behind the entire "Choosing Wisely" campaign, which I have written about on this blog in the past. Will Choosing Wisely campaign affect physician behavior? Read my opinion here (spoiler: Uh, no).

Some people have told me (some in a joking and some in a condesending way), "Hey Mike, since you're pushing social media so much, why not start a Facebook page called 'I'm Saying NO To Routine PSA Testing.'" Wouldn't that be an interesting social media experiment?

The point is that no one likes change (especially physicians) and no one likes to be told what to do (especially physicians). Physician behavior change is one of the most difficult to predict and no one single guideline, organization, medical study, or person is going to do it alone. However, as stubborn as we are, as we hear the drum beat getting louder (like in the well done video above), behavior change will occur, just not as quickly as some people would like...