Lifestyle health risk assessment. Do recently trained family physicians do it better?

OBJECTIVE To determine whether recently trained family physicians were more likely to routinely assess lifestyle health risks during general medical evaluations. To document physicians' perceptions of the difficulties of lifestyle risk assessment, of medical training in that area, and of how often they saw patients with lifestyle health risks.

DESIGN Anonymous mailed survey conducted in 1995.

SETTING Family practices in the province of Quebec.

PARTICIPANTS Stratified random sample of 805 active family physicians of 1111 surveyed; 25 were ineligible or could not be located, and 281 did not respond (74.1% response rate).

MAIN OUTCOME MEASURES Proportion of physicians graduating before and after 1989 who reported routinely (with 90% or more of their patients) assessing their adult and adolescent patients during general medical evaluations for substance use, sexual risk behaviours, and history of family violence and sexual abuse.

RESULTS Except for asking about drug use, recently trained family physicians did not report better assessment of lifestyle health risks during general medical examinations than family physicians who graduated more than 10 years ago did. In both groups, routine assessment averaged 82% for tobacco use, 68% for alcohol consumption, and 20% to 40% for sexual risk behaviours. Screening for family violence and sexual abuse was rare, but more frequently reported by older women physicians. Only 20% to 40% of recent graduates rated their medical training adequate for evaluating illicit drug use, family violence, and sexual abuse.

CONCLUSION Recently trained family physicians do not assess most lifestyle risk factors any better than their more experienced colleagues.