Clinical preventive services: the physician and the patient

Physicians have positive attitudes and beliefs about providing preventive services. Numerous constraints, however, influence provision of these preventive services, such as system/organizational problems, reimbursement issues, the science of clinical preventive services, and an authoritative source of information to guide physicians. Even in the best of circumstances, physicians are not as effective as they or their patients would like in providing clinical preventive services. The illness orientation is a powerful obstacle for even the most motivated physician to overcome. Many studies suggest activities that could improve physicians' compliance with their own attitudes toward preventive medicine. Patients are important partners in physician-patient interaction, and have a vital part in the provision of preventive services. But in most cases, patients are seen as passive partners in the preventive care service interaction, and this serves the patient and the physician poorly. Patients appear motivated to receive preventive services, but in some cases (e.g., immunizations), they may be misinformed about these services. The presence of a knowledgeable, activated patient will improve the provision of preventive services, and thus enhance community health.