Nurse consultation support to primary care practices to increase delivery of health behavior services

Tobacco use, lack of physical activity, poor diet, and alcohol use are the key preventable causes of death in the United States. This study tested the use of nurses as consultants to primary care practices to assist practice clinicians and staff in identifying and carrying out plans to help their adult patients improve these health behaviors. A pre–post chart audit was conducted, and 17 of 20 practices (85%, p = <.01) increased documentation of health behavior delivery a mean absolute increase of 5.5% after the intervention. Nurse consultation may be an effective strategy to increase health behavior delivery to patients in primary care.     

Residency Training in Preventive Medicine

In responding to questionnaires, directors of 37 of the 49 approved residency programs in preventive medicine (excluding aerospace medicine) reported that 285 physicians had entered such training in the academic years, 1960 to 1968. Of these, 92% proceeded into the second year, but only 45% continued into the third. Gainful employment, military service, and residency programs in other specialties were major avenues of loss. The chief difficulty in recruitment appeared to be lack of teaching and indoctrination in preventive medicine during medical school. The greatest monetary difficulties were related to instability of governmental funding and the fact that residents in preventive medicine usually do not fulfill a “service function” in academic settings. A significant number of full-time faculty positions in departments of preventive medicine are vacant. Respondents provided a number of suggestions for improvement.