RHP&EO is the electronic journal of the International Union for Health Promotion and Education

Is Prevention Part Of The General Practitioner's Task? Results From A Swedish Survey Of General Practitioners' Opinions

Agard Hakansson, MD, Margareta Troein, MD, PhD, Lennart Rastam, MD, PhD

Department of Community Medicine, University of Lund, Maimo, Sweden.

Purpose: To describe changes in view on prevention during the period as a general practitioner, expressed by Swedish general practitioners

Methods:. As a part of a larger survey on prevention in primary ca?.e,-210 randomly selected general practitioners received a postal questionnaire. One-hundred and twenty physicians participated (57%). The items concerned many aspects of physicians' preventive efforts.

Results: Questions concerning changes in views on prevention were addressed by 110 GPs. Seventy-nine GP's (72%) reported that their views on prevention in primary care had changed. Among these, 50 GPs (46%) had lost their initial positive views on the potential to perform prevention, which was based on the expectations on development of primary care and on self-efficacy for counselling. They attributed this to economic constraint in health care and to ambivalence to the benefits of prevention. Twenty-nine physicians (26%) reported that although their views had changed, their general attitude to prevention was still positive. They defined their current attitudes as more patient-centred and more focused on secondary prevention than earlier. GPs who did not report changes in view had remained negative (n=12; 11%), or did not remember (n=19; 17%).

In contrast to this, a majority of the physicians reported frequent primary preventive activities as part of their regular clinical work. Many such activities were, however, defined as curative rather than preventive by the physicians.

Discussion: Many general practitioners had changed their initially positive views on their possible role in prevention. Nonetheless, this study demonstrates a realistic level of which expectations that can be put on health care in public health- primarily focusing on the physicians role in primary and secondary disease prevention, mainly during the individual consultation?

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