The effects of peer review in general practice.

This paper describes the effects of an intensive, structured programme of peer review on the behaviour of general practitioners. Trained assessors evaluated 43 doctors before and after participating in the programme. Both the medical and non-medical performance of the general practitioners was assessed using a previously tested measuring instrument. In addition, the prescribing behaviour of the participants was compared with that of a control group. After taking part in the programme, the work of the general practitioners conformed more closely to a number of criteria for good general practice care. This was particularly true for clarifying the questions and expectations of the patients, active stimulation of patient involvement, history taking and providing information and advice to patients. The greatest change occurred among general practitioners who had previously conformed least with the established criteria. During peer review participants in the project prescribed fewer drugs, such as analgesics, tranquillizers and antibiotics, than before peer review while non-participants prescribed more. The value of these changes is discussed.