Finally, it is possible that unmeasured factors may have affected doctors' documentation of the smoking advice that they delivered to patients.
But be sure to ask your doctor for documentation for any over-the-counter medicine he or she recommends after Dec. 31.
There were four binary outcomes: 1) achievement of initiation of best medical therapy (BMT) within 24 hours of first presentation to a doctor; 2) documentation of behavioural counseling (including smoking cessation, diet/exercise, and driving advice); 3) achievement of CT scan; 4) achievement of carotid imaging.
Overall, the agreement between parental records and doctor's documentation was substantial (Cohen's kappa = 0.62, 95 % CI: 0.52 0.72) or almost perfect after exclusion of visits which were not related to the symptoms or where diary data was missing (Cohen's kappa = 0.82, 95 % CI: 0.73 0.91).
Although doctors have documentation about their patients' clinical histories, to facilitate autonomous decision making it is important to ask patients about treatments that, in their view, worked or did not work, as well as whether they have heard something positive or negative about treatments that they have not yet tried.
In 9.1% (457) we observed both a change of doctor and a documentation break of two or more intervals preceding re-enrolment.
The underlying assumption is that without this documentation, doctors will perpetrate fraud.
Throughout my (admittedly so far short) career, I see examples of this every day; nurses staying one to two hours late to complete their documentation, doctors staying late to take care of their sick patients – it seems to be ingrained in the culture of the NHS.
It was developed to decrease significantly the time required for doctors to obtain documentation about drugs.
Moreover, the satisfaction of our doctors regarding clinical documentation itself could be increased by our approach.
