Screening recommendations in general practice: a survey of graduates from different medical schools.

Abstract

OBJECTIVE: To examine the influence of sociodemographic background, medical school background, general practice characteristics and attitudes towards preventive medicine on the screening recommendations of New South Wales (NSW) general practitioners (GPs). METHODS: From the NSW Medical Board Register, a sample was obtained of all GPs who graduated between 1983 and 1987 from the University of Newcastle and a random 1-in-3 sample of GPs from the Universities of Sydney and NSW. Two questionnaires were mailed consecutively. PARTICIPANTS: 363 GPs (56% response rate) who completed questionnaires suitable for analysis. MAIN OUTCOME MEASURE: A composite screening score for assessing agreement with standard screening guidelines. The score was derived by allocating points to the screening intervals that GPs recommended for 13 screening tests. A score of 39 indicated maximum agreement with guidelines. RESULTS: 87% of GPs reported being aware of standard screening guidelines. For most screening tests, there was a discrepancy between GPs' recommendations and those of the guidelines. Composite screening scores ranged from 8-38. There were significantly higher screening scores for graduates of Newcastle versus Sydney and NSW university medical schools combined (adjusted mean, 28.0 versus 25.9; P=0.0436), group versus solo GPs (adjusted mean, 26.3 versus 25.6; P=0.0092) and GPs in rural versus urban locations (adjusted mean, 27.9 versus 25.6; P=0.0049). CONCLUSIONS: GPs' recommendations for screening are not always consistent with standard guidelines, despite an awareness of them. Research is needed into the variation with which different screening tests are ordered.