The ability of primary care physicians to obtain important clinical information in initial encounters with new patients is a core competency that has received little attention in previous studies.
This paper describes the history-taking and preventive screening skills of practicing primary care physicians in initial interactions with ambulatory patients, as determined by a large panel of standardized patients.
Standardized patient cases with diverse presentations were developed and used to assess the clinical skills of 134 primary care physicians from five Northwest states.
Scoring categories for each case identified the percentage and content of essential history items and preventive screening items performed.
Physicians'scores were compared by training and practice characteristics.
Physicians asked 59% of essential history items.
They frequently obtained appropriate information about presenting symptoms and medications, but they often missed important information about related symptoms and medical history.
Physicians frequently screened for smoking and alcohol use, but rarely asked about recreational drug use.
Although board-certified general internists performed more comprehensive histories than board-certified family practitioners in the same amount of time, both groups of providers missed a large number ofitems that should have been influential in developing diagnostic and treatment plans. (...)
Mots-clés Pascal : Soin santé primaire, Médecin, Prévention, Dépistage, Pratique professionnelle, Evaluation, Homme
Mots-clés Pascal anglais : Primary health care, Physician, Prevention, Medical screening, Professional practice, Evaluation, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0170458
Code Inist : 002B30A05. Création : 21/07/1998.