Physicians' responses to diagnostic test guidelines

Internists (IM), subspecialty internists (SS), and family practitioners (FP) were surveyed regarding their opinions of ten of the Blue Cross Blue Shield Association/American College of Physicians diagnostic test use guidelines applied to the asymptomatic periodic health exam. The majority of 390 respondents agreed with the guidelines (59% of all responses). There was at least 40% disagreement with seven of ten guidelines. Board certification was associated with agreement. Internists and family practitioners were more likely to agree than subspecialty internists. The number of years in practice had a negative correlation with agreement for five guidelines. HMO physicians tended to agree with guidelines that discouraged test ordering. Results indicate that these guidelines for test use, based on research data and developed cooperatively by physicians, are a starting point for guidelines to testing during the periodic health examination.