Open Access Highly Accessed Research article

Physicians' propensity to collaborate and their attitude towards EBM: A cross-sectional study

Daniele Mascia1*, Americo Cicchetti2, Maria Pia Fantini3, Gianfranco Damiani1 and Walter Ricciardi1

Author Affiliations

1 Department of Public Health, Catholic University of the Sacred Heart, Largo F. Vito, 1-00168 Rome, Italy

2 Department of Management, Catholic University of the Sacred Heart, Largo F. Vito, 1-00168 Rome, Italy

3 Department of Public Health, University of Bologna, Via San Giacomo 12-40126 Bologna, Italy

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BMC Health Services Research 2011, 11:172  doi:10.1186/1472-6963-11-172

Published: 25 July 2011



The healthcare management literature states that physicians often coordinate their activities within and between organizations through social networks. Previous studies have also documented the relationship between professional networks and physicians' attitudes toward evidence-based medicine (EBM). The present study sought associations between physicians' self-reported attitudes toward EBM and the formation of inter-physician collaborative network ties.


Primary data were collected from 297 clinicians at six hospitals belonging to one of the largest local health units of the Italian National Health Service. Data collection used a survey questionnaire that inquired about professional networks and physicians' characteristics. Social network analysis was performed to describe inter-physician professional networks. Multiple regression quadratic assignment procedures were performed to assess the relationship between self-reported attitudes toward EBM and clinicians' propensity to collaborate.


Physicians who reported similar attitudes toward EBM were more likely to exchange information and advice through collaborative relationships (β = 0.0198; p < 0.05). Similarities in other characteristics, such as field of specialization (β = 0.1988; p < 0.01), individual affiliations with hospital sites (β = 0.0845; p < 0.01), and organizational clinical directorates (β = 0.0459; p < 0.01), were also significantly related to physicians' propensity to collaborate.


Communities of practice within healthcare organizations are likely to contain separate clusters of physicians whose members are highly similar. Organizational interventions are needed to foster heterophily whenever multidisciplinary cooperation is required to provide effective health care.