Are primary care physicians missing opportunities for primary prevention?

Background Healthy people initiatives have called for more preventive services and health promotion. The purpose of the study was to assess self-reported levels of engagement in general health education (HEd) services among the medical (MD) and osteopathic (DO) primary care providers. Methods Multiple logistic regression was applied to the 2005-2007 National Ambulatory Medical Care Survey (NAMCS) data to assess the provision of HEd counseling by MDs and DOs with patient, visit, and practice characteristics. The complete multistage probability design structure was applied to generate national population estimates of patient visit encounters where HEd services were provided Results About 286 million patient visits were made to both provider groups during 2005-2007 with 7.5% to DOs and 92.5% to MDs. HEd was provided on 103.8 million (37.1%) visits. Fewer services were rendered as patient s aged but did not differ by gender. More HEd was offered to blacks than whites [OR 1.4, 95%CI(1.02, 1.27)] as were “other” races [OR=1.36, 95%CI(1.12,1.64)]. Providers were more likely to advise patients they diagnosed with hypertension, diabetes, or obesity but not based on computed blood pressure levels or body mass index. Self-paying patients were more likely to receive advice but general advice levels did not differ by provider group. Level of HEd increased with the involvement of nurses in patient care. Conclusion No significant difference in HEd engagement could be identified between MDs and Dos. Despite health care initiatives for primary prevention opportunities are still being missed by primary care physicians.