By Pamela Fayerman
Doctors who take preventive health measures like cancer screening advise patients to have similar good habits, a BC-Israeli study published in the Canadian Medical Association Journal has found.
The study, led by Erica Frank of UBC’s School of Population and Public Health, shows that physicians who adhered to recommended cancer screening or vaccination practices were more likely to counsel and have patients who do such things as flu shots, colorectal cancer screening for those aged 50 to 74, and cholesterol testing at various stages.
Forty-nine per cent of patients of physicians who received a flu shot also got the vaccine, compared to 43 per cent of patients whose physicians did not.
The first study of its kind delved into the electronic health records of nearly 1,500 Israeli family doctors in an organization called Clalit Health Services and the corresponding practices of their 1.9 million adult patients.
Besides the aforementioned tests, other interventions included blood pressure testing at certain increments, mammography for women aged 50 to 74, and pneumococcal (pneumonia) vaccination for those over 65 or individuals with health problems.
Dr. Frank said in an interview that physicians do practice what they preach. So if they take personal preventive health measures, they will be more likely to prescribe if for their patients.
Doctors who don’t have healthy tendencies use the same old excuses as everyone else – lack of time and the inconvenience of it all, she said.
So does this mean that patients should seek out doctors who look like the picture of health or that they should ask doctors about their personal practices? Should they go so far as to avoid doctors who don’t make time for such measures?
“All other variables being equal, the answer is yes,” Frank said, noting that previous research has shown that female doctors are more likely to recommend preventive health tests as are primary care (family) doctors over specialists.
As to whether patients should ask doctors about their personal practices, she said: “I don’t know. That might be a question of etiquette.”
Frank said because of her research focus on preventive health care and physician health, she would personally by “put off” by a doctor who didn’t seem too avid about living — and practicing — evidence based, preventive health care.
“People do expect doctors to be models of healthy practices,” she added, noting that data from previous studies shows that patients don’t have as much trust for doctors who appear visibly unhealthy, such as being overweight. “It’s hard to avoid that perception because of human nature.”
She’s hoping policy-makers pay the most attention to the results.
“The point of this is that by targeting a relatively small group — physicians — you can improve the health of the whole population. Physician health programs do work,” she said, noting that in a previous study she did on medical students, those who were counselled about a healthy diet and exercise were more likely to counsel patients about that.
While physician health programs tend to focus on strategies which promote mental health, the study concludes that going beyond that would pay bigger dividends:
“ …(W) e should improve physicians’ preventive practices because patient health could substantially benefit if we do so.”
Frank decided to collaborate with the Tel Aviv University researchers after she met one of them at an international conference on physician health. The country’s electronic records and organized health system in which patients are assigned to doctors, lends itself to such data collection on doctors and their patients.
Researchers were able to go back several years to observe whether there were appropriate intervals between tests.
Previous studies on the association between physician and patient health practices had been based on self-reported practices; this was the first to use actual health records.
Sun Health Issues Reporter