Women often miss out on cholesterol screening and nutrition counseling because their physicians do a poor job of following the recommended guidelines for cardiovascular care in women, according to a study in the September issue of Women�s Health Issues.
Doctors need to overcome external barriers, like a lack of reimbursement for preventive care, along with their own habits and beliefs about the guidelines to improve heart care, according to Michael Cabana, M.D., M.P.H., and Catherine Kim, M.D., M.P.H., of the University of Michigan Medical Center.
In fact, external barriers like access to care and multiple providers who do not communicate with each other may be the most significant obstacles to better care, the researchers say.
"Improving physician adherence to preventive care guidelines may not necessarily mean focusing entirely on the physician. Physician-level barriers are a starting point," Cabana says.
Using the American Heart Association�s guidelines for women�s preventive heart care, Cabana and Kim pinpoint several reasons why the guidelines might be ignored. Some physicians may lack information about new cholesterol management guidelines, for example. The researchers also suggest that physicians may feel unable to deliver the necessary nutritional or exercise counseling recommended for heart health.
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Other doctors may not bother with the guidelines because they think their patients won�t be able to follow their advice, while some see the guidelines as generalized "cookbook medicine" that devalues their personal practice.
"In general, physicians are more likely to be aware of and agree with guidelines developed by their own specialty organization," Cabana explains.
Continuing medical education to give physicians the skills and confidence to apply new guidelines, along with "external" improvements like reimbursement and computerized reminder systems, could improve women�s preventive care, the researchers conclude.
Source: Center for the Advancement of Health
