Physician, heal thyself? Regular source of care and use of preventive health services among physicians

Background: Little is known about the regular source of care (RSOC) among p hysicians, a group whose self-care may reflect the attitudes and recommenda tions they convey to their patients. Methods: We performed a cohort study of physicians who graduated from the J ohns Hopkins School of Medicine from 1948 through 1964 to identify predicto rs of not having an RSOC, and to determine whether not having an RSOC was a ssociated with subsequent receipt of preventive services. The RSOC was asse ssed in a 1991 survey; use of cancer screening tests and the influenza vacc ine was assessed in 1997. Results: The response rate in 1991 was 77% (915 respondents); 35% (312) had no RSOC. Internists (odds ratio [OR], 3.26; 95% confidence interval [CI], 1.58-6.74), surgeons (OR, 2.42; 95% CI, 1.17-5.02), and pathologists (OR, 5 .46; 95% CI, 2.09-14.29) were significantly more likely to not have an RSOC than pediatricians. Not having an RSOC was inversely related to the belief that health is determined by health professionals (OR, 0.45; 95% CI, 0.29- 0.68) and directly related to the belief that chance (OR, 1.90; 95% CI, 1.2 8-2.82) determines health. Not having an RSOC in 1991 predicted not being s creened for breast, colon, and prostate cancer, as well as not receiving an influenza vaccine at 6 years of follow-up. Conclusions: A large percentage of physicians in our sample had no RSOC, an d this was associated with both medical specialty and beliefs about control of health outcomes. Not having an RSOC was significantly associated with f ailure to use preventive services several years later.