The level of preventive health care in an internal medicine residency clinic: still only an ounce of prevention?
BACKGROUND
Clinical prevention is a critical component of primary care residency training. How well residents do preventive services is one measure of the adequacy of their training.


METHODS
To assess the level of preventive health care in a university internal medicine residency clinic, we conducted a randomized retrospective review of 225 patient records.


RESULTS
We documented preventive services in only 39% of potentially appropriate instances. Cholesterol screening occurred in 53% of eligible cases, breast examination in 41%, mammogram in 69%, Papanicolaou's smear in 53%, estrogen replacement therapy (ERT) in 41%, fecal occult blood testing in 30%, flexible sigmoidoscopy in 18%, influenza vaccination in 65%, pneumococcal vaccination in 44%, and tetanus immunization in only 9%. Male residents were significantly less likely than females to order mammograms or offer ERT.


CONCLUSIONS
Compared to earlier studies of similar design, we found that the level of preventive health care has improved during residency training, but remains unacceptably low.
Keim
D B
DB
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Gomez
C F
CF
Wolf
A M
AM
D000328:Adult; D000368:Aged; D003479:Curriculum; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009098:Multiphasic Screening; D010044:Outpatient Clinics, Hospital; D011314:Preventive Health Services; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D014768:Virginia