CANCER SCREENING BY PRIMARY-CARE PHYSICIANS - A COMPARISON OF RATES OBTAINED FROM PHYSICIAN SELF-REPORT, PATIENT SURVEY, AND CHART AUDIT

Objectives. This study measured the cancer screening rates of family p hysicians and compared the measures obtained through physician self-re ports, chart audits, and patient surveys. Methods. A cancer screening survey was sent to 50% of the members of the Washington Academy of Fam ily Physicians, with 326 family physicians (74% response rate) complet ing the survey. Sixty physicians were recruited for the patient survey and chart audit phase, with a 90% participation rate. Patient surveys were conducted with about 350 patients per physician, and chart audit s were conducted on a subset of about 50 patients per physician. Each physician's rate of providing each service was computed from the self- report, the patient survey, and the chart audit. Results. Physicians p rovided many of these services at rates different from those commonly recommended. Large discrepancies were found between the rates measured by different methods. Correlations between rates derived from chart a udits and patient surveys were high; however, correlations between rat es from physician self-report and either patient survey or chart audit were much lower for all services. Conclusions. Studies of physicians' provision of cancer prevention services should not rely on physician self-report, but should obtain the rates through patient surveys or ch art audits.