Routine breast examination and early detection of hypertension and diabetes mellitus by primary care physicians

Breast cancer is the leading cause of cancer mortality among women is Israel. On average, 1 in every 12 women develops the disease. While breast self-examination has not proved effective, and routine mass mammography is at present unavailable to the population at large, regular routine breast examination by primary care physicians can effectively screen a large fraction of this country's population. In order to do so, full acceptance of the procedure by women and their physicians is required. This study examines the attitudes and practice of primary care physicians with regard to routine breast examination, and compares them with routine detection of hypertension and diabetes mellitus. A structured questionnaire was distributed to all 97 Kupat Holim (workers' federation sick fund) primary care physicians in the Negev. They included 40 family physicians (FP), board-certified or completing specialization, and 57 general practitioners (GP), not board-certified. There was no difference in response rate between the 2 groups (47%). Nearly all physicians perform routine examinations for detection of hypertension (100% of the FP and 96% of the GP) and diabetes mellitus (91% and 74%, respectively). Of the FP, 96% consider routine breast examination as the task of the primary care physician, versus only 68% of the GP. Accordingly, 92% of the FP stated that they routinely perform the procedure, but only 52% of the GP. Being an FP was positively related with the performance of breast examination, while seeing a large number of patients per clinic session and low job satisfaction were negatively associated with it.