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McCormick and Jain suggest that one reason that physicians do not meet ADA guidelines is that they are poorly informed about these guidelines. Whether variation in the extent to which patients receive guideline-based care is a consequence of physicians' knowledge, beliefs, and attitudes about the guidelines vs patients' interest in adhering to the recommendations in the guidelines is an empirical question. Our study¹ suggests that some of this variation can be explained by the extent to which physicians and patients are truly engaging in a partnership that allows for a mutual exchange of opinions, ideas, and solutions. We also suspect that a frequently unmeasured determinant of quality of care, the system of care itself, may influence the degree to which guideline-based care is delivered. Multidisciplinary care teams, computerized reminder systems, and other disease management interventions have the potential to lower barriers to both physician and patient "adherence" by . . . [Full Text of this Article]

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