Preventive practice among primary care physicians in British Columbia: relation to recommendations of the Canadian Task Force on the Periodic Health Examination.
OBJECTIVE
To compare the current practice of preventive medicine in British Columbia with the recommendations of the Canadian Task Force on the Periodic Health Examination. Four common, preventable forms of cancer (cervical, breast, lung and colorectal) were used as sentinel conditions.


METHODS
Random sample mailed survey.


METHODS
Private primary care practices in British Columbia.


METHODS
A sample of 300 primary care physicians in 1991; of 285 eligible physicians 185 (65%) responded.


METHODS
Compliance with preventive practices recommended by the task force.


RESULTS
Preventive practice complied with the task force's recommendations for breast examinations, mammography, cervical smears and initial counselling against smoking; over 90% of the physicians performed these manoeuvres in all or most cases. However, less than half performed two recommended manoeuvres for all or most patients who smoke: advice to follow a diet high in beta-carotene (reported by 10%) and scheduling of follow-up visits to reinforce antismoking counselling (by 46%). Most of the physicians stated that they perform preventive manoeuvres in the context of an annual general physical examination rather than integrating them into routine patient care.


CONCLUSIONS
The task force's carefully constructed recommendations are incompletely followed. Overall, there appears to be a high level of compliance with traditional and recommended manoeuvres but also widespread persistence in performing traditional manoeuvres no longer recommended and failure to adopt new recommendations.
Smith
H E
HE
Department of Health Care and Epidemiology, University of British Columbia, Vancouver.
Herbert
C P
CP
D001943:Breast Neoplasms / Q000517:prevention & control; D001955:British Columbia; D002338:Carotenoids / Q000008:administration & dosage; D015179:Colorectal Neoplasms / Q000517:prevention & control; D003625:Data Collection; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000517:prevention & control; D008403:Mass Screening / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D010808:Physical Examination / Q000592:standards* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D011315:Preventive Medicine / Q000592:standards* / Q000706:statistics & numerical data; D012494:Sampling Studies; D016540:Smoking Cessation; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control
D002338:Carotenoids