Doctors' beliefs and the management of insulin dependent diabetes: implications for sharing care.

There have been many studies of the health beliefs of patients but relatively few have considered the beliefs of doctors and the influence these have on the management of a disease. This paper reviews the evidence that such beliefs are important and reports a preliminary study examining differences in the beliefs of doctors as a function of their experience and chosen specialty. Thirty four general practitioner teachers responded to a questionnaire measuring beliefs about diabetes and its management. The results were compared with those of a previous study among hospital doctors with an interest in diabetes. In comparison with hospital doctors, general practitioner teachers had a more pessimistic outlook on diabetes, perceiving that the disease carried more risks and having less confidence that achieving goals of treatment would reduce these risks. In accord with these beliefs their approach to treatment was less rigorous than that of hospital-based doctors. These results have implications for shared care; such differences between groups of doctors are likely to be a barrier to the effective sharing of patient care. The results also add further strength to the view that doctors' beliefs about a disease and its management need to be considered alongside those of the patient to explain more of the variance in patient health outcomes.