title: Comparing physicians personal prevention practices and their recommendations to patients.
abstract: BACKGROUND
  Hypothetical choice studies suggest that physicians often take more risk for themselves than on their patient's behalf.
  
  
  OBJECTIVE
  To examine if physicians recommend more screening tests than they personally undergo in the real-world context of breast cancer screening.
  
  
  METHODS
  Within-subjects survey.
  
  
  METHODS
  A national sample of female obstetricians and gynecologists (N = 135, response rate 54%) from the United States. In total, they provided breast care to approximately 2,800 patients per week.
  
  
  METHODS
  Personal usage history and patient recommendations regarding mammography screening and breast self-examination, a measure of defensive medicine practices.
  
  
  RESULTS
  Across age groups, female physicians were more likely to recommend mammography screening than to have performed the procedure in the past 5 years (86% vs. 81%, p = .10). In respondents aged 40-49 this difference was significant (91% vs. 82%, p < .05), whereas no differences were detected for younger or older physicians. Among respondents in their 40s, 18% had undergone annual screenings in the past 5 years, compared to 48% of their colleagues above 50. Respondents were as likely to practice breast self-examination (98%) as to recommend it (93%), a pattern that was consistent across age groups. A logistic regression model of personal use of mammography significantly predicted recommending the procedure to patients (OR = 15.29, p = .001). Similarly, number of breast self-examinations performed over the past 2 years positively predicted patient recommendations of the procedure (OR = 1.31, p < .001).
  
  
  CONCLUSIONS
  Obstetricians and gynecologists tended to recommend early mammography screening to their patients, though their personal practices indicated later start than their own recommendations and lower frequency of screening than peers in recent studies have recommended.
authors.forename: Pavel
authors.initials: P
authors.lastname: Atanasov
authors.forename: Britta L
authors.initials: BL
authors.lastname: Anderson
authors.forename: Joanna
authors.initials: J
authors.lastname: Cain
authors.forename: Jay
authors.initials: J
authors.lastname: Schulkin
authors.forename: Jason
authors.initials: J
authors.lastname: Dana
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000517:prevention & control; D016504:Breast Self-Examination / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006176:Gynecology; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D009774:Obstetrics; D010819:Physician's Role; D010820:Physicians; D011795:Surveys and Questionnaires