Elsevier

Public Health

Volume 127, Issue 3, March 2013, Pages 282-289
Public Health

Original Research
Screening tests among family doctors: do we do as we preach?

https://doi.org/10.1016/j.puhe.2012.12.010Get rights and content

Summary

Objective

To assess the attitudes and practices of family doctors from Southern Israel and their relatives concerning screening tests and disease prevention.

Study design

Cross-sectional survey.

Methods

Personal interview using a questionnaire that included sociodemographic data and questions related to family doctors' compliance with screening tests for early detection.

Results

One hundred and thirty-eight of 226 eligible doctors (61%) participated in the study, and 81 of them were female (58.7%). Most of the doctors (n = 82; 59.4%) reported a strong belief in the importance of screening tests, but only 27.5% (n = 38) actually underwent these tests themselves. The main reason for non-compliance was lack of time (n = 50; 55.6%). Older doctors (age ≥50 years) were more likely to have undergone lipidograms than younger doctors (P = 0.013). There were no significant differences in the attitudes of family medicine residents and experts in attitudes to screening tests. Only 64 (46.4%) doctors had received an influenza vaccination over the previous year, and this was significantly more common among residents than experts (P = 0.01).

Conclusions

Family doctors, who are supposed to be role models, believe that screening tests for disease prevention and health promotion are important, but do not undergo most of the recommended tests themselves.

Introduction

Recently, there has been a significant increase in awareness of screening tests for the early detection of disease and risk factors for disease. One aim of family doctors in clinical practice is to recommend that their patients undergo early detection testing. Modern medicine has not found a cure for many conditions, so the aim of screening is the early detection of disease to enable appropriate treatment, improve quality of life and promote public health. The guidelines in Israel for preventive medicine are based on the recommendations of the Israeli Task Force for Health Promotion and Disease Prevention, with a detailed list of recommended tests for each age group. The recommendations were last updated in 2008 through the work of a multidisciplinary committee.1

A literature search on medical treatment for healthcare providers shows that doctors receive different treatment compared with the general population. Doctors tend to treat themselves and their relatives by informal methods, using ‘hallway’ medicine alongside formal treatment.2 Hallway medicine is defined as informal and inappropriate self-referrals to specialists without prior consultation with a family physician (or other primary care provider), and without adequate medical record keeping or follow-up.3 A previous study showed that residents write themselves prescriptions for medicine.4 Doctors treat other doctors differently from other patients, and many doctors believe that they should receive health care without paying for it.5

Inasmuch as family doctors serve as role models for their patients, the conduct of screening tests among these doctors themselves is very important. Doctors' own attitudes and behaviours influence their ability to promote their patients' health care. An explanatory analysis revealed that doctors, as well as other healthcare providers, could be a main source of information on health and nutrition. Networked individuals have the potential to influence the health knowledge and information of large groups of people and, therefore, may serve as valuable change agents to disseminate health information.6

The present study assessed whether family doctors undergo recommended screening tests themselves, and reasons for non-compliance. No similar studies were found in a search of the literature, which was conducted prior to the development of the study questionnaire. The categories chosen for the study have been used in earlier research.3, 4, 5, 7, 8, 9, 10

Based on these principles, screening tests are just as important for doctors as for the general public. The study question was whether family doctors undergo screening tests for early detection of disease.

Section snippets

Methods

This study was conducted within the framework of the Southern District of Clalit Health Services. This is Israel's largest Health Maintenance Organization, and serves approximately 60% of the population of the Negev region in Southern Israel. The population for this region is approximately 550,000, and most people are of low to middle socio-economic status. The largest city in the area is Beer-Sheva, with approximately 200,000 residents; the rest of the population of the Negev's region live in

Sociodemographic characteristics of the study population (Table 1)

Two hundred and twenty-six doctors were asked to participate in the study. Of these, 138 completed the questionnaire (61%). Eighty-one doctors (58.7%) were women, and 123 (92.7%) were married. The mean age was 44.4 ± 9.1 years. Fewer than one-third of the participants were born in Israel.

Attitudes and practices regarding screening tests (Tables 2 and 3)

Eighty-two (59.4%) doctors expressed a strong belief in the need for screening tests among their colleagues. Similar attitudes were found when asked about screening tests for relatives. However, only 38 (27.5%)

Discussion

Although most of the doctors in this survey were of the opinion that they should have screening tests, only a minority had actually undergone these tests. A report on doctors' health9 showed that doctors have a tendency to deny disease and medical conditions, and only relate to their own health when they are seriously ill. They are afraid of losing control over their health, which makes it more difficult for a doctor who needs medical treatment or follow-up to get it. A study published in the

Ethical approval

None sought.

Funding

None declared.

Competing interests

None declared.

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