Oliveria Susan A, Altman Jamie F, Christos Paul J, Halpern Allan C
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Prev Med. 2002 Mar;34(3):374-9. doi: 10.1006/pmed.2001.0995.
Nonphysician health care providers are in an optimal position to provide cancer prevention and screening services.
We conducted a survey of primary care physicians to determine physician use and amenability to use of nonphysician health care providers to perform skin cancer screening in comparison with other cancer screening examinations.
A total of 1,363 eligible physicians completed the survey. Of these, 631 physicians (46%) reported a nurse practitioner or physician assistant performing at least one type of cancer screening examination on their patients. Twenty-nine and 22% of all physicians reported nurse practitioners or physician assistants performing skin cancer screening, respectively. Family physicians were more likely to use nurse practitioners and physician assistants to perform these cancer screening examinations than internists (chi(2) test, P = 0.001 for each examination). Skin examinations were performed less frequently by nurse practitioners and physician assistants than all other cancer screening examinations. A total of 73-79% of family physicians and 60-70% of internists were amenable to having a nonphysician health care provider perform one or more of these examinations.
Primary care physicians are currently utilizing nonphysician health care providers to perform cancer screening examinations and the majority of those surveyed are amenable to the use of these providers for such examinations. This suggests that one possible strategy for increasing skin cancer screening is through an expanded role of nonphysician health care providers.
非医师医疗服务提供者处于提供癌症预防和筛查服务的最佳位置。
我们对初级保健医生进行了一项调查,以确定与其他癌症筛查检查相比,医生使用非医师医疗服务提供者进行皮肤癌筛查的情况以及使用意愿。
共有1363名符合条件的医生完成了调查。其中,631名医生(46%)报告称执业护士或医师助理为他们的患者进行了至少一种类型的癌症筛查检查。所有医生中分别有29%和22%报告称执业护士或医师助理进行了皮肤癌筛查。与内科医生相比,家庭医生更有可能使用执业护士和医师助理进行这些癌症筛查检查(卡方检验,每项检查P = 0.001)。执业护士和医师助理进行皮肤检查的频率低于所有其他癌症筛查检查。共有73% - 79%的家庭医生和60% - 70%的内科医生愿意让非医师医疗服务提供者进行一项或多项此类检查。
初级保健医生目前正在利用非医师医疗服务提供者进行癌症筛查检查,并且大多数接受调查者愿意让这些提供者进行此类检查。这表明增加皮肤癌筛查的一种可能策略是扩大非医师医疗服务提供者的作用。