Medical students' and primary care physicians' opinions and concerns on the use of information technology

This study identified and categorized medical students' and primary care physicians' opinions of information technologies. Goals were: (1) to contribute to the understanding of physicians' resistance and acceptance, and (2) to provide baseline data for strategic decision-making in policy, pharmacy, and practice.;Six opinion types were identified: (1) Full-Range Adopters; (2) Skills-Concerned Adopters; (3) Technology-Critical Adopters; (4) Independently-Minded and Concerned: A Professional Dominance Frame; (5) Inexperienced and Worried: A Proletarianization Frame; and (6) Business-Minded and Adaptive. Full-Range Adopters embraced many uses and expressed no concerns. Skills-Concerned Adopters saw a similar range of uses and were concerned only about their personal computer skills. Both Technology-Critical Adopters and The Independently-Minded and Concerned combined misgivings about record confidentiality and security with rejection of performance assessment via computer monitoring. The Inexperienced and Worried distinguished themselves by displaying extreme concerns about depersonalizing effects and over-standardization of medical care. The Business-Minded and Adaptive were the only group who considered the use of computer-based record systems essential to compete for HMO and business contracts. The common denominator, connecting all six opinion types, was found to be increased efficiency in patient and office management activities, not improved access to the medical literature.;This study shows that some physicians accept information technologies with no apparent concerns; others are similarly accepting, but in need of computer training; while still others seem to resent the technology as a symptom of the underlying ideology. Addressing this type of resentment with systems training alone might not be sufficient. Instead, strategic interventions might also have to be targeted at the source--the physicians' apparent discomfort with managed care principles.;A total of 59 respondents participated: 25 third-year medical students, University of Illinois at Chicago (UIC), 16 UIC-affiliated family practice physicians, and 18 primary care physicians without known university affiliation. All participants rank-ordered 30 opinion statements from Most Agree to Most Disagree. Statements addressed a broad range of envisioned uses and issues of concern. Following Q-technique, rank-ordered sorts were subjected to correlation and by-person factor analysis to obtain groupings of participants who sorted the statements into similar arrangements.