Professional networks and EBM use: A study of inter-physician interaction across levels of care

Physicians around the globe are increasingly encouraged to adopt guidelines, protocols andother scientific material when making clinical decisions. Extant research suggests that theclinicians’ propensity to use evidence-based medicine (EBM) is strongly associated with theprofessional collaborative networks they establish and maintain with peers. In this paperwe explore whether and how the connectedness of primary care physicians with colleaguesworking in hospital settings is related to their frequency of EBM use in clinical practice. Weused survey data from 104 pediatricians working in five local health authorities in the Ital-ian NHS. Social network and attributional data concerning single physicians, as well as theirself-reported frequency of EBM use, were collected for three major pathologies in pediatriccare: asthmatic, gastro-enteric and urinary pathologies. Ordered regression analysis wasemployed. Our findings documented a positive association between the number of physi-cians’ relationships with hospital colleagues and the frequency of use EBM. Results alsoindicated that physicians’ organizational affiliations influence the frequency of EBM use.Finally, contrary to our expectations, it was found that clinicians’ affiliation to formal col-laborative arrangements is at odds with the likelihood of reporting higher frequency of EBMuse.