The level of preventive health care in an internal medicine residency clinic: still only an ounce of prevention?

South Med J. 1998 Jun;91(6):550-4. doi: 10.1097/00007611-199806000-00008.

Abstract

Background: Clinical prevention is a critical component of primary care residency training. How well residents do preventive services is one measure of the adequacy of their training.

Methods: To assess the level of preventive health care in a university internal medicine residency clinic, we conducted a randomized retrospective review of 225 patient records.

Results: We documented preventive services in only 39% of potentially appropriate instances. Cholesterol screening occurred in 53% of eligible cases, breast examination in 41%, mammogram in 69%, Papanicolaou's smear in 53%, estrogen replacement therapy (ERT) in 41%, fecal occult blood testing in 30%, flexible sigmoidoscopy in 18%, influenza vaccination in 65%, pneumococcal vaccination in 44%, and tetanus immunization in only 9%. Male residents were significantly less likely than females to order mammograms or offer ERT.

Conclusions: Compared to earlier studies of similar design, we found that the level of preventive health care has improved during residency training, but remains unacceptably low.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Curriculum
  • Female
  • Hospitals, University
  • Humans
  • Internal Medicine / education*
  • Internship and Residency*
  • Male
  • Middle Aged
  • Multiphasic Screening
  • Outpatient Clinics, Hospital
  • Preventive Health Services*
  • Quality Assurance, Health Care
  • Retrospective Studies
  • Virginia