Healthcare providers often deviate from guidelines, leading to worse outcomes. I study the impact of academic detailing (also known as educational outreach) to primary care teams on safer pain management, risk evaluation, harm reduction, and opioid use disorder treatment. Using data from over 5 million patients, I find detailing improves provider behavior: it increases naloxone prescribing, prescription drug monitoring queries, and reduces opioid prescriptions for three years. Patients have fewer emergency visits and hospitalizations for overdoses, suicides, and accidents, especially heavy opioid users. Importantly, pain scores remain stable despite reduced opioid use, highlighting detailing's role in fostering safer, effective care.

We use data from the Veterans Administration to examine the efficacy of primary care providers (PCPs). Leveraging quasi-random assignment of veterans to PCPs, we measure effectiveness using ambulatory care sensitive conditions (ACSC) and hospitalizations/emergency department (ED) visits for mental health or circulatory conditions. PCPs variation along these dimensions predicts future outcomes. For example, a one standard deviation improvement in mental health effectiveness reduces patient risk of death by 3.8% and lowers costs by 4.4% over the next three years. More effective PCPs do more with less: their patients have fewer primary care visits, specialist referrals, lab panels, or imaging tests.