Skip to main content
Log in

Periodic health examination

Comparison of residency programs and national recommendations

  • Original Articles
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

Health maintenance and disease prevention guidelines of primary care internal medicine residency (PCIM) programs were investigated and compared with recommendations of major national organizations. Preventive screening data were requested from 134 PCIM programs; 120 (90%) responded. Methods included seminars/lectures by 73 (61%), health maintenance flow sheets by 58 (48%), and a variety of other formats by 25 (21%) programs. A comparison of recommended flow sheet items (n=33) from five major studies and 48 PCIM programs showed concordances (±SE) of 62% (±5) with high-priority items (n=15) and 33% (±4) with low-priority items (n=18). When an item’s frequency or age range was examined, however, concordances were much lower. From our analysis, fewer than half the programs routinely used prompting systems, such as flow sheets, in their ambulatory clinics, and there was little uniformity in the frequencies and age ranges for those items employed. The data suggest that major study recommendations were underused and underemphasized.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Koch HC. The national ambulatory medical care survey: 1975 Summary. Hyattsville: US Department of Health, Education and Welfare, National Center for Health Statistics 1978:1–62

    Google Scholar 

  2. Romm FJ, Fletcher SW, Hulka BS. The periodic health examination: comparison of recommendations and internists’ performance. South Med J 1981;74:265–71

    PubMed  CAS  Google Scholar 

  3. American Cancer Society: Survey of physicians’ attitudes and practices in early cancer detection. CA 1985;35:197–213

    Google Scholar 

  4. Preventive Health Care Committee. Society for Research and Education in Primary Care Internal Medicine. Preventive medicine in general internal medicine residency training. Ann Intern Med 1985;102:859–61

    Google Scholar 

  5. Earp JA, Fletcher SW, O’Malley MS, Fletcher RH. Attitudes of internal medicine subspecialty fellows toward primary care. Arch Intern Med 1984;144:329–33

    Article  PubMed  CAS  Google Scholar 

  6. Woo B, Woo B, Cook EF, et al. Screening procedures in the asymptomatic adult. Comparison of physicians’ recommendations, patients’ desires, published guidelines, and actual practice. JAMA 1985;254:1480–4

    Article  PubMed  CAS  Google Scholar 

  7. Kosecoff J, Fink A, Brook R, et al. General medical care and the education of internists in university hospitals: an evaluation of the teaching hospital general medicine group practice program. Ann Intern Med 1985;102:250–7

    PubMed  CAS  Google Scholar 

  8. Williams JS, Sanders CR. Cost effectiveness and cost-benefit analysis of vaccines. J Infect Dis 1981;144:486–93

    Google Scholar 

  9. Davidson RA, Fletcher SW, Retchin SM, et al. A nurse initiated reminder system for the periodic health examination. Implementation and evaluation. Arch Intern Med 1984;144:2167–70

    Article  PubMed  CAS  Google Scholar 

  10. McDonald CJ, Hui SL, Smith DM, et al. Reminders to physicians from an introspective computer medical record: a two-year randomized trial. Ann Intern Med 1984;100:130–8

    PubMed  CAS  Google Scholar 

  11. Medical Practice Committee, American College of Physicians. Periodic health examinations: a guide for designing individualized preventive health care in the asymptomatic patient. Ann Intern Med 1981;95:729–32

    Google Scholar 

  12. Council on Scientific Affairs, Division of Scientific Activities, American Medical Association. Medical evaluations of healthy persons. JAMA 1983;249:1626–33

    Article  Google Scholar 

  13. American Cancer Society: ACS report on the cancer-related checkup. CA 1980;30:194–232

    Article  Google Scholar 

  14. Breslow L, Somers AR. The lifetime health monitoring program. N Engl J Med 1977;296:601–8

    Article  PubMed  CAS  Google Scholar 

  15. Frame PS, Carlson SJ. A critical review of periodic health screening using specific screening criteria. J Fam Pract 1975;2:29–36, 123–9, 189–94, 283–9

    PubMed  CAS  Google Scholar 

  16. Canadian Task Force on the Periodic Health Examination. The periodic health examination. Can Med Assoc J 1979;121:1193–254

    Google Scholar 

  17. Preventive Services for the Well Population, Report of the Institute of Medicine, National Academy of Sciences. Healthy people (appendices). Washington, DC, US Department of Health, Education and Welfare 1978;1–22

    Google Scholar 

  18. Shapiro S, Venet W, Strax W, et al. 10–14 year effect of screening on breast cancer mortality. JNCI 1982;69:349–55

    PubMed  CAS  Google Scholar 

  19. Carter WB, Belcher DW, Inui TS. Implementing preventive care in clinical practice: problems for managers, clinicians, and patients. Med Care Rev 1981;38:195

    Article  PubMed  CAS  Google Scholar 

  20. Fletcher SW. The periodic health examination and internal medicine: 1984. Ann Intern Med 1984;101:866–7

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Received from the General Internal Medicine Division, Department of Medicine, Wright State University School of Medicine, Miami Valley Hospital, Dayton, Ohio.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Goldenberg, K. Periodic health examination. J Gen Intern Med 1, 282–286 (1986). https://doi.org/10.1007/BF02596204

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02596204

Key words

Navigation