Primary care physicians' decisions to perform flexible sigmoidoscopy

被引:23
作者
Lewis, JD [1 ]
Asch, DA [1 ]
Ginsberg, GG [1 ]
Hoops, TC [1 ]
Kochman, ML [1 ]
Bilker, WB [1 ]
Strom, BL [1 ]
机构
[1] Univ Penn, Div Gastroenterol, Philadelphia, PA 19104 USA
关键词
cancer screening; sigmoidoscopy; sex factors; physicians' practice patterns;
D O I
10.1046/j.1525-1497.1999.00337.x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
OBJECTIVE: This study was designed to identify factors that influence primary care physicians' willingness to perform flexible sigmoidoscopy. MEASUREMENTS: 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. MAIN 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.
引用
收藏
页码:297 / 302
页数:6
相关论文
共 29 条
[1]  
*AM CANC SOC, 1989, SUMM CURR GUID CANC
[2]  
*AM COLL PHYS, 1990, CLIN EFF ASS PROJ SC
[3]  
[Anonymous], CA CANC J CLIN
[4]  
Armitage P, 1987, Statistical methods in medical research, V2nd
[5]  
BALLAS MT, 1995, J FAM PRACTICE, V40, P535
[6]  
BUCKLEY RL, 1988, J FAM PRACTICE, V27, P197
[7]  
BUCKLEY RL, 1988, J FAM PRACTICE, V27, P575
[8]   Relation of family responsibilities and gender to the productivity and career satisfaction of medical faculty [J].
Carr, PL ;
Ash, AS ;
Friedman, RH ;
Scaramucci, A ;
Barnett, RC ;
Szalacha, L ;
Palepu, A ;
Moskowitz, MA .
ANNALS OF INTERNAL MEDICINE, 1998, 129 (07) :532-+
[9]   Primary care physician recommendations for colorectal cancer screening - Patient and practitioner factors [J].
Cooper, GS ;
Fortinsky, RH ;
Hapke, R ;
Landefeld, CS .
ARCHIVES OF INTERNAL MEDICINE, 1997, 157 (17) :1946-1950
[10]   The new medical marketplace: Physicians' views [J].
Donelan, K ;
Blendon, RJ ;
Lundberg, GD ;
Calkins, DR ;
Newhouse, JP ;
Leape, LL ;
Remler, DK ;
Taylor, H .
HEALTH AFFAIRS, 1997, 16 (05) :139-148