Special ArticlesHistory-taking and Preventive Medicine Skills among Primary Care Physicians: An Assessment Using Standardized Patients☆
Section snippets
Subject Selection and Description
To identify eligible physicians, a screening questionnaire about practice activities was mailed to physicians in Washington, Alaska, Montana, Idaho, and Oregon who listed their primary or secondary specialty as either internal medicine, family practice, or general practice in the American Medical Association Directory. Eligibility criteria based on information from screening questionnaires included (1) at least 50% of professional time spent in primary care activities, and (2) medical school
Results
Among 134 participants, 36 were women. Nearly half practiced in large metropolitan areas, and the remainder were evenly divided between small metropolitan and nonmetropolitan locations. Nearly half (66) were board-certified in internal medicine, and 45% (n = 60) in family practice. Fourteen internists were also certified in at least one subspecialty of internal medicine. Most participants (96%) were American medical graduates. Physicians were equally divided between those practicing in solo or
Discussion
The standardized patient examination provides a method to assess physicians’ ability to elicit essential information during initial patient encounters. Patient presentations can be controlled prospectively so that all physicians see the same patients and are evaluated in a standardized manner. In this study, we used standardized patients to assess the clinical data-gathering skills of 134 primary care physicians. The results provide insights into the strengths and weaknesses of primary care
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Supported by Grant #06454, the Agency for Health Care Policy and Research.