Original ResearchScreening tests among family doctors: do we do as we preach?
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.
References (15)
- Tabenkin H, Israel Family Medicine Association, Summary, Israel Task Force on Health Promotion and Disease Prevention....
- et al.
Hallway medicine: prevalence, characteristics and attitudes of hospital physicians
Isr Med Assoc J
(1999) - et al.
Hallway medicine: prevalence and patterns of informal medical consultation among medical students
Educ Health
(1999) - et al.
Prescription drug use and self-prescription among resident physicians
J Am Med Assoc
(1998) - et al.
Professional courtesy – current practices and attitudes
N Engl J Med
(1993) - et al.
Practicing what they preach: health behaviors of those who provide health advice to extensive social networks
J Health Commun
(2009) - et al.
Physician, heal thyself? Regular source of care and use of preventive health services among physicians
Arch Intern Med
(2000)