Sociological Model for Understanding Medical Practice Variations

Medical practice variations have been known to exist since the 1930s. The literature revealed that these variations were not random. Clear patterns of variation were found on several levels, for example, in countries, regions, hospitals, and physicians. The question, therefore, is less why physicians take different medical decisions but, more importantly, why physicians within geographical or organizational units show similarities even though differences exist between those units. In this chapter, a sociological model explaining medical practice variations is proposed. The importance of constraints and institutional mechanisms is shown, and time trends and the influence of the physician-patient interaction are elaborated upon.