Clinical inertia

L. S. Phillips, Jr Branch, C. B. Cook, J. P. Doyle, I. M. El-Kebbi, D. L. Gallina, C. D. Miller, D. C. Ziemer, C. S. Barnes

Research output: Contribution to journalReview article

984 Scopus citations

Abstract

Medicine has traditionally focused on relieving patient symptoms. However, in developed countries, maintaining good health increasingly involves management of such problems as hypertension, dyslipidemia, and diabetes, which often have no symptoms. Moreover, abnormal blood pressure, lipid, and glucose values are generally sufficient to warrant treatment without further diagnostic maneuvers. Limitations in managing such problems are often due to clinical inertia-failure of health care providers to initiate or intensify therapy when indicated. Clinical inertia is due to at least three problems: overestimation of care provided; use of "soft" reasons to avoid intensification of therapy; and lack of education, training, and practice organization aimed at achieving therapeutic goals. Strategies to overcome clinical inertia must focus on medical students, residents, and practicing physicians. Revised education programs should lead to assimilation of three concepts: the benefits of treating to therapeutic targets, the practical complexity of treating to target for different disorders, and the need to structure routine practice to facilitate effective management of disorders for which resolution of patient symptoms is not sufficient to guide care. Physicians will need to build into their practice a system of reminders and performance feedback to ensure necessary care.

Original languageEnglish (US)
Pages (from-to)825-834
Number of pages10
JournalAnnals of internal medicine
Volume135
Issue number9
DOIs
StatePublished - Nov 6 2001

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ASJC Scopus subject areas

  • Internal Medicine

Cite this

Phillips, L. S., Branch, J., Cook, C. B., Doyle, J. P., El-Kebbi, I. M., Gallina, D. L., Miller, C. D., Ziemer, D. C., & Barnes, C. S. (2001). Clinical inertia. Annals of internal medicine, 135(9), 825-834. https://doi.org/10.7326/0003-4819-135-9-200111060-00012