Busy physicians and preventive services for adults

Objective: To study the relationship between overall productivity and the r ates at which primary care physicians, in a fee-for-service setting, delive r or prescribe preventive services to adult patients. Patients and Methods: The charts of 452 adult patients treated by 8 family practitioners and 5 internists in a fee-for-service practice setting were r andomly selected and abstracted for provision of 10 preventive services ove r a 27-month period. The percentage of eligible patients screened for each service was correlated with the production of each physician measured in re lative value units (RVUs), Results: The correlation coefficient between RVUs and the aggregate of the 10 services was 0.23 (95% confidence interval [CI], -0.36 to 0.70. The indi vidual correlation coefficients between RVUs and 9 of the 10 preventive ser vices ranged from -0.05 to 0.43. For cervical cancer screening, however, th e correlation coefficient was -0.72 (95% CI, -0.91 to -0.24). Conclusion: With the exception of screening for cervical cancer, the data p resented in this study do little to support physicians' common belief that lack of time is the reason they are unable to incorporate prevention strate gies into their clinical practice.