Researchers are investigating how health care is delivered in order to come up with better ways for patients to be treated. The field, called health services research, began with the finding that in different locations, patients would be treated very differently, with resulting differences in costs and outcomes. People realized that this variation probably means that there wasn’t uniformly ideal medical care across the country.

On our show today, Dr. Steve Feldman talks with John Piette, Ph.D., Senior Research Career Scientist at the Veterans Administration and Professor of Internal Medicine, Director of the Program on Quality Improvement for Complex Chronic Conditions at the University of Michigan. In this first of a two-part program, Dr. Piette describes health services research and why health care delivery seems to vary so much, including economic, behavioral and organizational issues. Dr. Piette describes some of the problems with how doctors get their information, in particular physician detailing by drug companies and the impact this has on patients’ care.