Practice settings and prescribing profiles: the simulation of tension headaches to general practitioners working in different practice settings in the Montreal area.

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Abstract
This study determined whether physicians practicing in one type of setting manage a medical problem differently than those practicing in another type of setting. Physicians were presented with a simulated case of tension headache with a history going back 3 yr, for which diazepam had been taken daily for the past year. Four simulated patients (aged 20-23) visited a stratified random sample of 111 general practitioners practicing in health centers funded by the government (CLSC) and in private group practice clinics in the Montreal [Canada] area. Of group practice physicians, 51% recommended therapy rated as inadequate compared to 25% in CLSC; there were also significant differences between CLSC and group practice physicians in performing various aspects of the clinical examination. Alternative explanations for the observed differences are discussed.

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