PREVENTIVE CARE AND BARRIERS TO EFFECTIVE PREVENTION - HOW DO FAMILY PHYSICIANS SEE IT

OBJECTIVES To assess how adequately family physicians think they are d elivering preventive care and to examine barriers to providing prevent ive care. DESIGN Cross-sectional survey SETTING Primary care medical p ractices in south-central Ontario. PARTICIPANTS Four hundred eighty fa mily physicians and general practitioners who graduated from medical s chool between 1972 and 1988. MAIN OUTCOME MEASURES Satisfactory preven tive care delivery versus self-assessed coverage of patients for 15 pr eventive maneuvers. Perceived reasons for lack of success in providing recommended preventive care. RESULTS For 10 of the 15 maneuvers, the proportion of physicians who regarded 90% or higher as satisfactory co verage was twice as great as the proportion who thought they provided that level of coverage. For 11 of the 15 maneuvers, most respondents r eported coverage lower than the level they regarded as satisfactory Fo r six maneuvers, more than two thirds thought they provided less than satisfactory coverage. More than two thirds of respondents suggested t hese barriers to providing recommended preventive care: patient is hea lthy and does not visit; patient refuses, is not interested, or does n ot comply; no effective systems to remind patients to come in for prev entive care; and priority given to presenting problem. CONCLUSION Many family physicians and general practitioners in south-central Ontario provide preventive care to their patients at lower levels than they co nsider satisfactory. They identified barriers to providing preventive services successfully; these barriers suggest approaches for improving care.