Health promotion and disease prevention in the elderly. Comparison of house staff and attending physician attitudes and practices

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Abstract
The purpose of this study was to evaluate and compare attending physician and house staff attitudes and practices regarding health promotion and disease prevention in the elderly. Seventy-four physicians (38 house staff and 36 attending physicians) were surveyed from four sites in Pittsburgh, Pa [Pennsylvania, USA], regarding their agreement with recommendations of the American Cancer Society and the Canadian Task Force. Two hundred fifty patients were interviewed and their charts were reviewed for performance of the recommendations. In all patients, physicians agreed highly with the American Cancer Society and the Canadian Task Force recommendations (agreement, 80% to 100%) with the exception of proctoscopy and thyroid examinations. Physicians performed screening procedures much less frequently. House staff and attending physicians differed regarding their attitudes about prevention. House staff felt the need for more formal instruction and were more positive regarding a healthy life-style and commitment to health promotion. The significant predictors of tests (defined as either examination or test ordered by a physician) were presence of a checklist, site of practice, and physician status. A logistic regression analysis was performed; however, this model could not entirely explain the variations found. Although physicians agreed with recommendations for screening, the attending physicians and house staff (particularly attending physicians) were less likely to perform the screening, especially in the elderly.