Mayo Clinic Proceedings Home

Busy Physicians and Preventive Services for Adults


      To study the relationship between overall productivity and the rates at which primary care physicians, in a fee-for-service setting, deliver or prescribe preventive services to adult patients.

      Patients and Methods

      The charts of 452 adult patients treated by 8 family practitioners and 5 internists in a feefor-service practice setting were randomly selected and abstracted for provision of 10 preventive services over a 27- month period. The percentage of eligible patients screened for each service was correlated with the production of each physician measured in relative value units (RVUs).


      The correlation coefficient between RVUs and the aggregate of the 10 services was 0.23 (95% confidence interval [Cl], −0.36 to 0.70). The individual correlation coefficients between RVUs and 9 of the 10 preventive services ranged from −0.05 to 0.43. For cervical cancer screening, however, the correlation coefficient was −0.72 (95% CI, −0.91 to −0.24).


      With the exception of screening for cervical cancer, the data presented in this study do little to support physicians' common belief that lack of time is the reason they are unable to incorporate prevention strategies into their clinical practice.
      AMC (Austin Medical Center), CI (confidence interval), RVU (relative value unit)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Mayo Clinic Proceedings
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Kotike TE
        • Solberg LI
        • Brekke ML
        • Cabrera A
        • Marquez MA
        Deliver)' rales for preventive services in 44 midwestem clinics.
        Mayo Clin Proc. 1997; 72: 515-523
      1. Healthy People 2000: National Health Promotion and Disease Prevention Objectives. US Government Printing Office, Washington, DC1991 (Publication PHS 91-50212.)
        • US Preventive Services Task Force
        Guide to Clinical Preventive Services. 2nd ed. Williams & Wilkins, Baltimore, Md1996
      2. Healthy People 2000: Midcourse Review and 1995 Revisions. US Government Printing Office, Washington, DC1995
        • Lewis CE
        Disease prevention and health promotion practices of primary care phvsicians in the United States.
        Am J Prev Med. 1988; 4: 9-16
        • Kottke TE
        • Brekke ML
        • Solberg LI
        Making “time” for preventive services.
        Mayo Clin Proc. 1993; 68: 785-791
        • Gemson DH
        • Elinson J
        Cancer screening and prevention: knowledge. attitudes, and practices of New York City physicians.
        N Y State J Med. 1987; 87: 643-645
        • Jacobsen SJ
        • Xia Z
        • Campion ME
        • et al.
        Potential effect of authorization bias on medical record research.
        Mayo Clin Proc. 1999; 74: 330-338
        • Hsiao WC
        • Braun P
        • Becker ER
        • Thomas SR
        The Resource-Based Relative Value Scale: toward the development of an alternative physician payment system.
        JAMA. 1987; 258: 799-802
        • Hsiao WC
        • Braun P
        • Yniema D
        • Becker ER
        Estimating physicians' work for a resource-based relative-value scale.
        N Engl J Med. 1988; 319: 835-841
        • Sncdecor GW
        • Cochran WG
        Statistical Methods. 7th ed. Iowa State University Press, Ames1980: 185-188
        • Hemenway D
        • Killen A
        • Cashman SB
        • Parks CL
        • Bicknell WJ
        Physicians' responses to financial incentives: evidence from a for-profit ambulatory care center.
        N EngUMed. 1990; 322: 1059-1063
        • Ogrod ES
        Compensation and quality: a physician's view.
        Health Aff (Millwood). 1997; 16: 82-86