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Could be a positive or negative thing

Study finds surgeon utilization of breast MR is influenced by their peers

by Lauren Dubinsky , Senior Reporter
Social contagion has mostly been the focus of sociology research, but a new study from Yale and Johns Hopkins revealed one way that peer influence is impacting the delivery of health care.

The research, which was published in the Journal of the National Cancer Institute, found that surgeons' use of breast MR imaging is influenced by the utilization practices of their colleagues.

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It's already well known that the medical field is heavily influenced by patient attitudes and beliefs, reimbursement issues and medical evidence, Dr. Cary P. Gross, lead author and director of Yale's Cancer Outcomes Public Policy and Effectiveness Research Center, said in a statement.

"Our study adds a new wrinkle to the literature," he added. "We found that physicians, like any other group of interconnected individuals, are also susceptible to the social influence of their physician peers."

The use of breast MR prior to surgery is not routine and is often reserved for patients with dense breasts, according to breastcancer.org. Some professional societies even recommend against it, which makes it the ideal focus of the research.

Gross and his team used Medicare data to identify surgeon peer groups that frequently share patients with one another. They then determined which surgeons were using breast MR on their patients.

Their goal was to find out if the surgeons who didn't initially use breast MR but had peers who did, were more likely to subsequently use it. After following the surgeons over time they found that the physician peer groups had an impact.

Patients with surgeons in physician peer groups with the highest use of breast MR were more likely to receive the exam than those with surgeons with peers that did not use breast MR. The rate was 24.9 percent compared to 10.1 percent, respectively.

Gross concluded that peer influence can have both positive and negative outcomes. It could increase the use of medical approaches that aren't based on sound evidence or it could be used to promote best practices among physicians.

"That's the exciting part — this concept of social contagion could be a potentially effective way of changing physician behavior and improving the quality of care," he said.

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