PHYSICIAN PREVENTIVE CARE PHILOSOPHY AND THE 5-YEAR DURABILITY OF A PREVENTIVE SERVICES OFFICE SYSTEM

A group of 30 community physicians who practiced in northeastern Unite d States and who participated in the Cancer Prevention in Community Pr actice project in 1988 were interviewed five years later. The aim of t he interviews was to assess the long-term impact of the preventive ser vices office system which had been introduced by the project. The qual itative analysis of interviews revealed three distinct physician philo sophies about the provision of preventive services: a Request Only foc us, responding to specific patient inquiries about prevention but taki ng no initiative to recommend indicated services; a Health Maintenance Visit focus, providing indicated services only during visits specific ally scheduled for preventive care; and an Opportunistic Prevention fo cus, providing indicated preventive services at every chance. Physicia ns demonstrated these philosophies in their overall view of disease pr evention, perceived obstacles to delivery of preventive care, as well as in their continued use of flow sheets and their impression of the v alue of the Cancer Prevention in Community Practice project. The long- term impact of the office system was most apparent in the Opportunisti c Prevention group. We conclude that the durability of a preventive se rvices office system is influenced by a physician's preventive care ph ilosophy. Copyright (C) 1996 Elsevier Science Ltd