Barriers to Evidence-Based Physician Decision-Making at the Point of Care: A Narrative Literature Review

The authors conduct a narrative literature review using four real-world cases of clinical decisions to show how barriers to the use of evidence-based medicine affect physician decision-making at the point of care, and where adjustments could be made in the healthcare system to address these barriers. Their four cases constitute decisions typical of the types physicians make on a regular basis: diagnostic testing, initial treatment and treatment monitoring. To shed light on opportunities to improve patient care while reducing costs, they focus on barriers that could be addressed through changes to policy and/or practice at a particular level of the healthcare system. The authors conclude by relating our findings to the passage of the Medicare Access and Children’s Health Insurance Program Reauthorization Act in April 2015.