Primary care physicians' decisions to perform flexible sigmoidoscopy.
OBJECTIVE
This study was designed to identify factors that influence primary care physicians' willingness to perform flexible sigmoidoscopy.


METHODS
Using a mailed questionnaire, we surveyed all 161 primary care physicians participating in a large health care system. We obtained information on training, current practice patterns, beliefs about screening for colorectal cancer, and the influence of various factors on their decision whether or not to perform flexible sigmoidoscopy in practice.


RESULTS
Of the 131 physicians included in the analysis, 68 (52%) reported training in flexible sigmoidoscopy, of whom 36 (53%) were currently performing flexible sigmoidoscopy in practice. Time required to perform flexible sigmoidoscopy, availability of adequately trained staff, and availability of flexible sigmoidoscopy services provided by other clinicians were identified most often as reasons not to perform the procedure in practice. Male physicians were more likely than female physicians to report either performing flexible sigmoidoscopy or desiring to train to perform flexible sigmoidoscopy (odds ratio 2.61; 95% confidence interval 1.10, 6.23). This observed difference appears to be mediated through different weighting of decision criteria by male and female physicians.


CONCLUSIONS
Approximately half of these primary care physicians trained in flexible sigmoidoscopy chose not to perform this procedure in practice. Self-perceived inefficiency in performing office-based flexible sigmoidoscopy deterred many of these physicians from providing this service for their patients.
Lewis
J D
JD
Division of Gastroenterology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia 19104, USA.
Asch
D A
DA
Ginsberg
G G
GG
Hoops
T C
TC
Kochman
M L
ML
Bilker
W B
WB
Strom
B L
BL
D000328:Adult; D000367:Age Factors; D000368:Aged; D002983:Clinical Competence; D015179:Colorectal Neoplasms / Q000517:prevention & control; D003625:Data Collection; D003657:Decision Making; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods*; D012737:Sex Factors; D012812:Sigmoidoscopy / Q000379:methods / Q000706:statistics & numerical data*