Evaluation of patient-care protocol use by various providers.

A symptom-oriented protocol for acute pharyngitis was evaluated in a busy general medical clinic staffed by physicians and graduate and student physician's assistants. We observed significantly improved performance by all providers in collection of medical data, utilization of laboratory tests,and appropriate use of antibiotics after introduction of the protocol. Patient charges were less when the protocol was used, but these savings were offset partially by the cost of audit. Compliance with and acceptance of the protocol differed among the various health providers, with physicians demonstrating significantly lower levels than nonphysicians. Patient-care protocols provide an effective means of monitoring the process of medical care, detecting weakness in supportive clinic services, and affording educational feedback for all health providers.