Comparing physicians personal prevention practices and their recommendations to patients

Area of Science:

• Oncology
• Public Health
• Medical Ethics

Background:

• Physician risk-taking behavior may differ between personal and patient care.
• Previous studies suggest physicians may adopt a more conservative approach for themselves compared to their patients.

Purpose of the Study:

• To investigate if physicians recommend more breast cancer screening tests than they personally utilize.
• To assess real-world discrepancies in mammography screening and breast self-examination practices among obstetricians and gynecologists.

Main Methods:

• A national survey of 135 female obstetricians and gynecologists in the United States.
• Data collected on personal mammography screening history and patient recommendations.
• Breast self-examination practices were also assessed as a measure of defensive medicine.

Main Results:

• Female physicians were more likely to recommend mammography screening (86%) than to have undergone it recently (81%), with a significant difference in the 40-49 age group.
• Physicians in their 40s reported lower personal mammography screening rates (18% annually) compared to older colleagues (48% >50).
• Personal mammography use strongly predicted patient recommendations (OR=15.29), as did breast self-examination frequency (OR=1.31).

Conclusions:

• Obstetricians and gynecologists tend to recommend earlier mammography screening for patients than their personal practices suggest.
• Physicians' personal screening frequency may lag behind their recommendations and current guidelines.
• Discrepancies in personal versus recommended screening highlight areas for improving physician adherence to guidelines.