A five-year demonstration project associated with improvement in physician health maintenance behavior

The purpose of this demonstration project was to evaluate the effect of a sustained preventive medicine emphasis in a community hospital based family practice residency. A simplified, visually tolerable, and prominent "health maintenance guide" served as the cornerstone of the overall residency educational effort. Screening interventions and intervals were based on the major published recommendations at the initiation of the project. An audit of 100 random adult patient charts was done at baseline and yearly for five years. Physicians received both group and individual feedback regarding screening compliance on a regular basis. Overall physician compliance with screening for six basic parameters improved from 71% to 85% (P less than .0005). Physicians behavior improved significantly in recording or recommending blood pressure, physician breast exam, personal life change, tetanus/diphtheria immunization, mammography, breast self-examination, testicular self-examination, and a prudent diet. Physician use of the guide as a recording device steadily increased.