The adoption of preventive care practice guidelines by primary care physicians - Do actions match intentions?

Scoff Weingarten, Erin Stone, Robert Hayward, Sean Tunis, Mitch Pelter, Hanqiang Huang, Raymond Kristopaitis

Research output: Contribution to journalArticlepeer-review

78 Scopus citations


OBJECTIVE: To measure primary care physicians' familiarity with, attitudes toward, and confidence in preventive care practice guidelines for the elderly and to determine whether their attitudes are associated with implementation of guidelines into clinical practice. DESIGN: A self-administered survey of physicians employed by a health maintenance organization (HMO) and of patients cared for by those physicians. Medical records were also reviewed to assess compliance with practice guidelines. SETTING: An HMO in Southern California. PARTICIPANTS: Forty-eight primary care physicians completed the survey (100% response rate). The medical records of 3,249 randomly selected elderly patients (65 to 75 years old) were studied. Of these patients, 2,799 completed a preventive care survey (response rate 86.1%). MEASUREMENT AND RESULTS: Most HMO primary care physicians agreed or strongly agreed that guidelines will improve quality of medical care (88%) and that guidelines have caused them to change their care of patients (73%). Although the physicians' general attitudes about guidelines did not often correlate with their use of preventive care guidelines, the physicians who stated that practice guidelines had changed their practices were more likely to offer their patients clinical breast examinations (75.9% vs 67.2%, p=0.04) and to counsel their patients to exercise (70% vs 58%, p=0.01) than were the physicians who did not. There was a significant association between physicians' support for and adoption of specific practice guidelines regarding mammography (r=0.34, p=0.02) and immunizations against influenza (r=0.42, p

Original languageEnglish (US)
Pages (from-to)138-144
Number of pages7
JournalJournal of General Internal Medicine
Issue number3
StatePublished - Mar 1995
Externally publishedYes


  • practice guidelines
  • practice patterns
  • prevention
  • primary care physicians

ASJC Scopus subject areas

  • Internal Medicine


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