OBJECTIVE To determine whether recently trained family physicians were more
likely to routinely assess lifestyle health risks during general medical e
valuations. To document physicians' perceptions of the difficulties of life
style risk assessment, of medical training in that area, and of how often t
hey saw patients with lifestyle health risks.
DESIGN Anonymous mailed survey conducted in 1995.
SETTING Family practices in the province of Quebec.
PARTICIPANTS Stratified random sample of 805 active family physicians of 11
11 surveyed; 25 were ineligible or could not be located, and 281 did not re
spond (74.1% response rate).
MAIN OUTCOME MEASURES Proportion of physicians graduating before and after
1989 who reported routinely (with 90% or more of their patients) assessing
their adult and adolescent patients during general medical evaluations for
substance use, sexual risk behaviours, and history of family violence and s
exual abuse.
RESULTS Except for asking about drug use, recently trained family physician
s did not report better assessment of lifestyle health risks during general
medical examinations than family physicians who graduated more than 10 yea
rs ago did. In both groups, routine assessment averaged 82% for tobacco use
, 68% for alcohol consumption, and 20% to 40%, for sexual risk behaviours.
Screening for family violence and sexual abuse was rare, but more frequentl
y reported by older women physicians. Only 20% to 40% of recent graduates r
ated their medical training adequate for evaluating illicit drug use, famil
y violence, and sexual abuse.
CONCLUSION Recently trained family physicians do not assess most lifestyle
risk factors any better than their more experienced colleagues.