Staying current in-patient care: how physicians in medically underserved areas gain knowledge for health care decision-making

Objectives: The purpose of this study was to explore the ways primary care physicians who practice medicine in medically underserved areas (MUA/Ps) maintain knowledge for patient care and decision making.

Methods: A qualitative research study utilizing semi-structured interviews and physician observations of ten diverse primary care physicians who work in medically underserved areas in one southern state was analyzed to describe their experiences in obtaining information for patient care and decision making. Participation was limited to primary care physicians who have worked in health centers designated as MUA/Ps for at least five years. The physicians who participated in this research were selected via convenience sampling. An inductive process in ATLAS.ti Web was used to determine common themes.

Results: The findings of the study revealed that despite some barriers to information seeking such as time constraints, access issues, database complications, and inadequate information seeking skills, physicians in MUA/Ps seek information to aid in practicing evidence-based patient care when possible. The study also found that these physicians are mostly self-directed in their learning to maintain knowledge for patient care, and are mostly motivated by patient safety, proliferation of biomedical literature, need to be lifelong learners and their status as patient educators.

Conclusions: Overall, the knowledge gained from this study can be used to increase support by health sciences librarians and public health networks for physicians who practice in MUA/Ps. Some of the barriers can be alleviated through partnerships and collaborations with health sciences librarians, finding opportunities for instruction including making physicians aware of open access biomedical literature.
Limitations: The findings are limited by the small sample size of convenience, the study design which relied heavily on self-reports and perceptions, and the setting. Implications and recommendations for practice, research, medical education, and health sciences librarianship will be discussed.