Altering physician behavior to improve clinical performance.

Increasing public awareness of the need to improve quality in health care and to limit unexplained variations in clinical practice have promoted interest in altering physician behavior. Unfortunately, many programs for changing the practice patterns of providers have proven less effective than anticipated. Interventions have often been initiated without a clear understanding of their theoretical basis or the empiric data supporting their use. This article reviews the various interventions available for altering physician behavior and their evidence of effectiveness.