PHYSICIAN AND PRACTICE CHARACTERISTICS ASSOCIATED WITH JUDGMENTS ABOUT BREAST-CANCER-TREATMENT

Since most cancer is treated in the local community, the judgments of primary care physicians about treatment of breast cancer are important . This study examined physician and practice characteristics associate d with physician judgments about the treatment of Stage I and Stage II breast cancer. Data are combined from samples of 3,436 physicians: ph ysicians affiliated with hospitals participating in the Community Clin ical Oncology Program (CCOP) and a national sample of non-CCOP physici ans. This study focused on 1,460 physicians who had seen breast cancer patients and participated in treatment decision-making. Judgments wer e elicited using brief vignettes. Judgments were more variable for Sta ge I than for Stage II treatments. Judgments consistent with the NIH C onsensus Conferences on breast cancer were more likely from surgeons, physicians who participated in information networks focused on cancer, and those with more breast cancer patients. Concurrence with the cons ensus conference positions was less likely in older physicians and tho se in solo practice. These findings point to structures that reinforce quality of care, particularly those that enhance communication, such as group practice or the activities of hospital staffs, information ne tworks, and organized continuing education.