Biomedical Engineering Reference
In-Depth Information
or do residency in the same hospital know each other and develop social ties.
Also, these physicians probably look up to the physicians who belong to the faculty
of the school or hospital as opinion leaders. Second, physicians who work together
in a group practice or in a hospital may have similar patterns of prescribing drugs
and treating certain illnesses. The senior physicians in the group practice or hospital
may be the opinion leaders and may decide on specialists whom they would refer
their patients to. These specialists are usually regional specialists who often end up
influencing the physicians in the group practice. Third, physicians routinely attend
seminars for continuing learning credit or are members of a professional society
where they meet other physicians and develop social connections. The speakers at
these seminars and conferences end up influencing the prescribing pattern of physi-
cians as well. Depending on the level of the seminar, the speakers are usually
regional or national key opinion leaders. The national key opinion leaders are
usually physicians who publish research in the therapeutic area, are involved in
clinical trials, write guidelines for treatment of the disease and are thought leaders
in their area. The key opinion leaders vary by therapeutic area and tend to be
specialists.
There are different ways in which information diffuses in the physician social
networks. One way in which information is disseminated in the network is when
new information about drugs or therapies is released in the physician community.
These could be new drug launches (or lately drug withdrawals), new drug efficacy
or comparison studies, new therapy or treatment guidelines, etc. The new informa-
tion creates uncertainty about efficiency of these therapies, wherein an opinion
leader steps in to answer the questions raised by other physicians about which
patients would be most suited for drug withdrawal or for prescribing the new drugs,
when and on whom to apply the new therapies, whether to change current prescrip-
tion behavior gradually with new patients or change therapy for existing patients.
The information is disseminated through meetings and conferences by the key opin-
ion leaders who are sometimes part of the clinical trial team, or who have published
new studies in top academic journal, or have helped shape the new guidelines.
Another way in which information is disseminated in the network is sourced
from the physicians who treat a lot of patients, perhaps specialists who are affiliated
with hospitals and large clinics, or those heading large physician practices. These
physicians are aware of the side effects of different drugs and have learned which
therapies work on a certain patient profile. So, these physicians act as opinion lead-
ers for physicians unsure about the patient-drug match, or those uncertain about
therapy side effects. Typically the information disseminates through a physician
referral for a patient from a general practitioner to a specialist. The general practi-
tioner is unsure about the best drug for this particular patient, or the patient is
suffering from some side effects on the current therapy, and the general practitioner
refers him to a specialist whom she looks up to. The general practitioner receives
feedback from the specialist (Bhatia and Wang
2011
) and learns how to treat similar
cases in the future. Hence knowledge disseminates from a specialist to a general
practitioner in the direction opposite to the referral. Specialists also work in teams
and can be influenced by physicians of other specialties or subspecialties whom
they refer patients to.
Search WWH ::
Custom Search