Dimensions of being “Modern” in medical practice

The timing of the introduction of new drugs into the individual physician’s practice and then into other aspects of the use of modern drugs are looked into.

Abstract

I N ORDER to learn something of the way in which medical innovations make their way into the doctor’s practice, intensive interviews were conducted with 216 physicians in four midwestern cities, and their replies were subjected to statistical analysis. A previous article’ described how the use of a new medication spread gradually among most of the 125 general practitioners, pediatricians, and internists among them. (This was ascertained by examining pharmacists’ prescription records covering a 16-month peri0d.t) This account constitutes a case history of the diffusion of a single innovation, a relatively minor variant of a well-established family of drugs. One cannot presume that the findings presented so far would necessarily hold true for innovations of other kinds or under other conditions. One wonders, nevertheless, whether the doctors who were first to use this particular drug would again be first the next time a new drug is introduced and whether they are progressive in other respects as well. This is an intriguing question; for, on the one hand most doctors know that they evaluate each proposed innovation on its own merits and, on the other hand, one keeps hearing some doctors described as “quick to jump on the bandwagon ,” or as “individuals that try everything that comes along,” while others are characterized as “stodgy doctors” who “are not interested in hearing about new techniques and want things to go on as they are.” Are such descriptions mere caricatures, or is there really some generalized tendency or trait of “innovatingness” which is strong in some doctors and weak or absent in others? This article is designed to answer this question, to the extent that an answer is possible on the basis of the data gathered. We will first look into the timing of the introduction of new drugs into the individual physician’s practice and then into other aspects of the use of modern drugs. Later we will turn to some broader questions of modern practice.