Family physicians are responsible for providing care for acute illnesses and chronic conditions. They also provide preventive services, including screening, immunizations, and behavioral counseling. In the disease-based model of health care, preventive care is often viewed as a competing demand. Americans, however, made more than 480 million visits in 2002 to their primary care physicians. As a trusted and well-used source of information and care, the family physician has a tremendous opportunity to improve the health of individual patients and entire communities through the provision of preventive services.
The good news is that family physicians, despite limited face-to-face time with patients, already spend a significant amount of time promoting health behaviors. One large study found that physicians addressed health behaviors during one half of all visits, spending on average more than 10% of the visit promoting health (Stange et al., 2002).
Further improvements in the provision of preventive services require more than improving clinician knowledge and attitude. Improving the quality, delivery, and effectiveness of prevention in primary care office practice requires changes in the office system. The family physician and other primary care clinicians must be integrated into a larger health care delivery team.
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