November 27, 2000
MEDIA CONTACT : Karen Infeld
One In Three Physicians Unlikely To Get Routine Medical Care
Doctor, heal thyself? That seems the motto among a group of physicians
surveyed by Johns Hopkins researchers: More than a third said they were
unlikely to see a doctor on a regular basis.
Of 915 physicians queried by the Hopkins team, 312 (34 percent) said they had
no regular source of care. Internists, surgeons and pathologists were
significantly less likely to have a regular health provider than pediatricians
or psychiatrists, the survey found. And those that reported no regular
source of care were less likely to get flu shots or recommended breast, colon
and prostate cancer screenings over the next six years.
Results of the study, published in the Nov. 27 issue of the Archives of
Internal Medicine, also reported that those less likely to get regular medical
attention reject care because they think it's unnecessary. They either
believe they can take care of themselves or that their health is a matter of
luck or chance.
"The interventions that physicians didn't take advantage of – mainly
screening for colon cancer – also are practiced less among the general
population," says Michael J. Klag, M.D., M.P.H., interim chairman for the
Department of Medicine at Hopkins and director of the study.
"Still, because physicians' health beliefs and practices influence how
they treat patients, we would like to see all health providers take advantage
of these potentially life-saving medical tests."
The doctors surveyed were less likely to have a regular care provider than
those in the general population, where about 15 percent don't have a regular
source of care. But overall, physicians' use of preventive health
measures was much higher than that of the general population, "so on
average, physicians do practice what they preach," Klag says.
The research team, led by Cary P. Gross, M.D., drew their survey subjects from
the Johns Hopkins Precursors Study, a long-term investigation of 1,337 medical
students, mostly male, enrolled at Hopkins between 1948 and 1964 who are
surveyed every year about health behaviors and disease occurrence. The
average age of the respondents was 61; 8 percent were women. Researchers
looked at whether the physicians used a regular health provider in 1991, and
compared that to whether they underwent various cancer screenings or got flu
shots in 1997.
Those who had no regular source of care included the 252 (28 percent) who had
no medical care at all, and the 60 (7 percent) who treated themselves.
Approximately 43 percent had an independent physician as their main source of
care, while 18 percent saw a colleague in their own medical practice.
Not having a regular doctor was unrelated to age or gender but did vary widely
by specialty, ranging from 21 percent among psychiatrists to 46 percent among
pathologists. Internists were most likely to report self-treatment.
Nearly three-quarters (73 percent) of the entire survey population had colon
cancer screening, 71 percent of the women a mammogram, 76 percent a PSA test
and 74 percent a flu shot. Among those who didn't have a regular doctor
in 1991, only 55 percent underwent a colon cancer screening, 44 percent had
mammograms, 62 percent had a PSA test, and 59 percent had a flu shot.
Researchers also asked the survey group whether they believed their health was
controlled by chance, by their own means or by others. Among those who
strongly felt health was up to chance, nearly 43 percent had no regular care
provider. About 40 percent of those who felt internal means could
control their health lacked a health provider and only 21 percent of those who
felt others have control over their health lacked a health provider.
Senior author Daniel E. Ford, M.D., M.P.H., indicated that such health beliefs
likely affect most people's decision to seek preventive medical care.
A history of cancer in one or both parents did not influence the physicians'
choice to have a regular health provider.
Klag cautions that these data are limited to graduates of The Johns Hopkins
University School of Medicine and may not apply to other doctors or the
The study was supported by the National Institutes of Health and the Robert
Wood Johnson Clinical Scholars Program. Other authors were Lucy A. Mead,
Sc.M.; and Ford of Hopkins; and Gross of Yale University School of Medicine,
New Haven, Conn. Gross was a Robert Wood Johnson Clinical Scholar at
Hopkins when the study was conducted.