Abstract
We compared the practices of subspecialists and general internists in counseling about smoking and exercise, using data from a study of recent graduates of United States training programs in internal medicine. Information on the characteristics of physicians and their clinical practices was obtained from self-report questionnaires. The internists most likely to counsel smokers regardless of the presence or absence of diseases associated with smoking are cardiologists, pulmonary specialists, nephrologists, and generalists trained in a primary care residency funded by the Robert Wood Johnson Foundation or Health Resources Administration. Most internists practice tertiary prevention by counseling a high percentage of smokers with heart or lung disease. Rheumatologists counsel a higher percentage of all patients with poor exercise habits but a lower percentage of such patients with heart disease than do other internists. The differences in counseling related to training are not explained by different levels of involvement as a primary care physician. Rather, these differences appear to reflect training and subspecialty-specific priorities for counseling.
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- Aiken L. H., Lewis C. E., Craig J., Mendenhall R. C., Blendon R. J., Rogers D. E. The contribution of specialists to the delivery of primary care. N Engl J Med. 1979 Jun 14;300(24):1363–1370. doi: 10.1056/NEJM197906143002404. [DOI] [PubMed] [Google Scholar]
- Bourke G. J., Wilson-Davis K., Thornes D. Smoking habits of the medical profession in the Republic of Ireland. Am J Public Health. 1972 Apr;62(4):575–580. doi: 10.2105/ajph.62.4.575. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Coe R. M., Brehm H. P. Smoking habits of physicians and preventive care practices. HSMHA Health Rep. 1971 Mar;86(3):217–221. [PMC free article] [PubMed] [Google Scholar]
- Green D. E., Horn D. Physicians' attitudes toward their involvement in smoking problems of patients. Dis Chest. 1968 Sep;54(3):180–185. doi: 10.1378/chest.54.3.180. [DOI] [PubMed] [Google Scholar]
- Mendenhall R. C., Girard R. A., Abrahamson S. A national study of medical and surgical specialties. I. Background purpose, and methodology. JAMA. 1978 Sep 1;240(9):848–852. [PubMed] [Google Scholar]
- Scheffler R. M., Weisfeld N., Ruby G., Estes E. H. A manpower policy for primary health care. N Engl J Med. 1978 May 11;298(19):1058–1062. doi: 10.1056/NEJM197805112981905. [DOI] [PubMed] [Google Scholar]
- Spiegel J. S., Rubenstein L. V., Scott B., Brook R. H. Who is the primary physician? N Engl J Med. 1983 May 19;308(20):1208–1212. doi: 10.1056/NEJM198305193082007. [DOI] [PubMed] [Google Scholar]
- Thomas N. Smoking attitudes of New Haven county physicians: a survey. Conn Med. 1968 Dec;32(12):902–905. [PubMed] [Google Scholar]
- Wechsler H., Levine S., Idelson R. K., Rohman M., Taylor J. O. The physician's role in health promotion--a survey of primary-care practitioners. N Engl J Med. 1983 Jan 13;308(2):97–100. doi: 10.1056/NEJM198301133080211. [DOI] [PubMed] [Google Scholar]
- Wells K. B., Lewis C. E., Leake B., Ware J. E., Jr Do physicians preach what they practice? A study of physicians' health habits and counseling practices. JAMA. 1984 Nov 23;252(20):2846–2848. [PubMed] [Google Scholar]
- Wells K. B., Ware J. E., Jr, Lewis C. E. Physicians' practices in counseling patients about health habits. Med Care. 1984 Mar;22(3):240–246. doi: 10.1097/00005650-198403000-00007. [DOI] [PubMed] [Google Scholar]