Improving physician prescribing practices: bridge over troubled waters.

The amelioration of drug prescribing practices holds out the prospect of improving health outcomes without increasing health care spending or the demands on hospital and ambulatory services. The challenge is to permit prescribers to assert their leadership as patient advocates while addressing the need for greater support in therapeutic decision making. Best practice includes the optimal use of drug and nondrug therapies and must be supported by research and the timely dissemination of information. The individualization of drug therapy will remain critical to quality prescribing and will depend on the appropriate preparation of prescribers for clinical decision making. The principal issues in improving prescribing practices were addressed at a workshop held by the CMA in Ottawa in October 1995, documents from which will be published in CMAJ, beginning with this issue (see pages 635 to 640). These issues deserve consideration by everyone with a stake in both cost-effectiveness and quality of care.