Busy physicians and preventive services for adults

To study the relationship between overall productivity and the rates at which primary care physicians, in a fee-for-service setting, deliver or prescribe preventive services to adult patients.

The charts of 452 adult patients treated by 8 family practitioners and 5 internists in a fee-for-service practice setting were randomly selected and abstracted for provision of 10 preventive services over a 27-month period. The percentage of eligible patients screened for each service was correlated with the production of each physician measured in relative value units (RVUs).

The correlation coefficient between RVUs and the aggregate of the 10 services was 0.23 (95% confidence interval [CI], -0.36 to 0.70). The individual correlation coefficients between RVUs and 9 of the 10 preventive services ranged from -0.05 to 0.43. For cervical cancer screening, however, the correlation coefficient was -0.72 (95% CI, -0.91 to -0.24).

With the exception of screening for cervical cancer, the data presented in this study do little to support physicians' common belief that lack of time is the reason they are unable to incorporate prevention strategies into their clinical practice.