The full content of Annals is available to subscribers

Subscribe/Learn More  >
Ideas and Opinions |

Clinical Inertia

Lawrence S. Phillips, MD; William T. Branch Jr., MD; Curtiss B. Cook, MD; Joyce P. Doyle, MD; Imad M. El-Kebbi, MD; Daniel L. Gallina, MD; Christopher D. Miller, MD; David C. Ziemer, MD; and Catherine S. Barnes, PhD
[+] Article, Author, and Disclosure Information

From Emory University School of Medicine, Atlanta, Georgia.

Grant Support: In part by awards from the Agency for Healthcare Research and Quality and the National Institutes of Health: T32-DK-07298 (Dr. Miller) and DK-48124 and HS-09722 (Dr. Phillips).

Acknowledgment: The authors thank Dr. David Ballard for encouragement, support, and thoughtful review of the manuscript.

Requests for Single Reprints: Lawrence S. Phillips, MD, Division of Endocrinology, Emory University School of Medicine, 1639 Pierce Drive, Room 1301, Atlanta, GA 30322; e-mail, medlsp@emory.edu.

Current Author Addresses: Drs. Phillips, Branch, Cook, Doyle, El-Kebbi, Gallina, Miller, Ziemer, and Barnes: Emory University School of Medicine, 1639 Pierce Drive, Atlanta, GA 30322.

Ann Intern Med. 2001;135(9):825-834. doi:10.7326/0003-4819-135-9-200111060-00012
Text Size: A A A

Medicine has traditionally focused on relieving patient symptoms. However, in developed countries, maintaining good health increasingly involves management of such problems as hypertension, dyslipidemia, and diabetes, which often have no symptoms. Moreover, abnormal blood pressure, lipid, and glucose values are generally sufficient to warrant treatment without further diagnostic maneuvers. Limitations in managing such problems are often due to clinical inertia—failure of health care providers to initiate or intensify therapy when indicated. Clinical inertia is due to at least three problems: overestimation of care provided; use of “soft” reasons to avoid intensification of therapy; and lack of education, training, and practice organization aimed at achieving therapeutic goals. Strategies to overcome clinical inertia must focus on medical students, residents, and practicing physicians. Revised education programs should lead to assimilation of three concepts: the benefits of treating to therapeutic targets, the practical complexity of treating to target for different disorders, and the need to structure routine practice to facilitate effective management of disorders for which resolution of patient symptoms is not sufficient to guide care. Physicians will need to build into their practice a system of reminders and performance feedback to ensure necessary care.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.