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Hutchison honoured as family medicine 'pioneer'

26 Aug 2015

Dr. Brian Hutchison has been named one of the Top 20 Pioneers of Family Medicine Research in Canada for his early work in the 1990s using simulated office patients as an innovative research methodology.

The award was recently announced by the College of Family Physicians of Canada.

Hutchison was CHEPA’s director from 2002 until his retirement in 2005 and is a professor emeritus in McMaster’s departments of family medicine and clinical epidemiology and biostatistics.

As a family physician and clinical teacher during the 1970s and early 1980s, Hutchison questioned some of the ways family medicine and primary health care were funded, organized and delivered.

In the mid-1990s, he and colleagues Christel Woodward, Geoffrey R. Norman,
Julia Abelson and Judy Brown obtained funding from Health Canada’s National Research and Development Program to study the provision of preventive care by family physicians. The research team recognized that traditional methods to assess the provision of preventive care, such as patient surveys, clinical records review and physician self-reporting, are limited by potential bias, measurement error and incomplete documentation.

They developed an innovative methodology using unannounced standardized patients to assess the extent to which family physicians provided age and gender appropriate evidence-based preventive care.

Posing as new patients, the standardized patients visited the practices of consenting, randomly-selected family physicians with open practices and portrayed four scenarios: a 48-year-old man, a 70-year-old man, a 28-year-old woman and a 52-year-old woman. This approach allowed for the examination of the association between preventive care performance and physician and practice characteristics.

The approach was so effectively implemented that only two per cent of encounters were detected by the practicing physician.

The main paper reporting on the study, Provision of preventive care to unannounced standardized patients
 (CMAJ 1998; 158:185-193), has been frequently cited and sourced.

The specific methodology was subsequently adapted by Quebec researchers in a randomized controlled trial evaluating a workshop to enhance the appropriate use of screening tests by family physicians.

A statement from the College says the awards are in honour of the 20th anniversary of the college’s research section and the winners were chosen for demonstrating  “the value of research that is informed by doctor-patient relationships, continuity of care, community and population connections, and commitment to teaching - the very attributes that family doctors bring to Canadians on a daily basis."

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