Direct observation of counseling on colorectal cancer in rural primary care practices

To better understand colorectal cancer (CRC) screening practices in primary care, medical students directly observed physician-patient encounters in 3 8 physician offices. CRC was discussed with 14% of patients greater than or equal to 50 years of age; 87% of discussions were initiated by the physici an. The rate of discussions varied among the practices from 0% to 41% of of fice visits. Discussions were more common for new patient visits, with youn ger patients, and in the 24% of offices that utilized flow sheets. The freq uency of CRC discussions in physician offices varies widely. More widesprea d implementation of simple office systems, such as flow sheets, Is needed t o improve CRC screening rates.