Improving preventive health care in a medical resident practice.

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Abstract
IN 1990 the US Preventive Services Task Force1,2 recommended a list of primary and secondary preventive health services (PHS). While physicians support the concept of PHS, in practice they fall short of recommended national guidelines.3-11 Existing outcome studies12,13 show compliance rates below expected levels in various practice models. Similar results have also been noted with internal medicine resident practices in teaching hospitals.14,15 There is further evidence that PHS outcomes are especially deficient in inner-city populations.16,17 This study compared PHS compliance rates in our resident practice (RP) with those of our collaborative nurse practitioner practice (NP), both serving inner-city patients. Results showed that the RP had significantly lower rates of provision of PHS. An intervention to improve provision of PHS in the RP was implemented, and at the end of 1 year, postintervention performances of 6 secondary PHS were analyzed.