HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dietrich, A J Articles by Goldberg, H Search for Related Content PubMed PubMed Citation Articles by Dietrich, A J Articles by Goldberg, H

Preventive content of adult primary care: do generalists and subspecialists differ?

A J Dietrich and H Goldberg

We compared preventive care performed by 20 generalists and 20 subspecialists practicing in Santa Clara and San Mateo Counties, California, by auditing charts of adult primary care patients for compliance with recommendations of the Canadian Task Force on the Periodic Health Examination. Generalists and subspecialists both provided 49 per cent of recommended preventive services. The two groups did not differ significantly in performance of any individual service. Performance varied widely within both groups. Of many factors explored, only two were associated with more preventive services: provision of a complete physical examination to the patient, and a physician's belief in the importance of a given service. The "generalist vs. subspecialist" debate assumes that a physician's specialty classification is an important predictor of behavior. For the performance of preventive care, this was not true in our study. Instead, physicians' beliefs and practice habits may be major determinants of the quality of preventive care provided. These exploratory findings needed confirmation in other settings.

This article has been cited by other articles:

				G. E. Fryer Jr, L. A. Green, S. M. Dovey, B. P. Yawn, R. L. Phillips, and D. Lanier Variation in the Ecology of Medical Care Ann. Fam. Med, July 1, 2003; 1(2): 81 - 89. [Abstract] [Full Text] [PDF]

				R. B. Williams, M. Boles, and R. E. Johnson A Patient-Initiated System for Preventive Health Care: A Randomized Trial in Community-Based Primary Care Practices Arch Fam Med, July 1, 1998; 7(4): 338 - 345. [Abstract] [Full Text] [PDF]

				R. A. Rosenblatt, L. G. Hart, L.-M. Baldwin, L. Chan, and R. Schneeweiss The Generalist Role of Specialty Physicians: Is There a Hidden System of Primary Care? JAMA, May 6, 1998; 279(17): 1364 - 1370. [Abstract] [Full Text] [PDF]

				B. Hutchison, S. Birch, C E. Evans, L. J Goldsmith, B. A Markham, J. Frank, and M. Paterson Screening for hypercholesterolaemia in primary care: randomised controlled trial of postal questionnaire appraising risk of coronary heart disease BMJ, April 18, 1998; 316(7139): 1208 - 1213. [Abstract] [Full Text]

				L. J. Cardozo, J. Steinberg, M. B. Lepczyk, L. Binns-Emerick, Y. Cardozo, and A. N. F. Aranha Improving Preventive Health Care in a Medical Resident Practice Arch Intern Med, February 9, 1998; 158(3): 261 - 264. [Abstract] [Full Text] [PDF]

				J. M. E. Walsh and S. J. McPhee A Systems Model of Clinical Preventive Care: An Analysis of Factors Influencing Patient and Physician Health Educ Behav, July 1, 1992; 19(2): 157 - 175. [Abstract] [PDF]