Patient care by a single primary care physician is linked to many health benefits, including increased treatment adherence and decreased hospital admissions and mortality risk.
But can the relationship built between doctor and patient also lead to unnecessary care?
In a new study, researchers found that men who have a single general physician were more likely to receive a prostate cancer screening test when the test was not recommended by the US Preventive Services Task Force.
The research was conducted by a team at the University of Florida.
In 2012, the US Preventive Services Task Force recommended against prescribing the prostate-specific antigen, or PSA, test, rating it a grade D test.
It concluded there is moderate or high certainty the test has no net benefit or that the harms—including false-positive results, overtreatment and treatment complications—outweigh the benefits.
This recommendation stayed in place until May 2018, when the task force upgraded the PSA test to a grade C, one that is selectively offered based on a physician’s professional judgment and patient preferences.
While use of the PSA test declined between 2012 and 2018, many men continued to receive the test during that period.
In the study, the team analyzed data from a nationwide system of health-related telephone surveys. They looked at data from 2016, four years after the task force’s recommendation against PSA tests.
They evaluated responses from men ages 40 and older with no symptoms or family history of prostate cancer.
Survey questions asked if participants had a single personal doctor if they had ever received a PSA test and what recommendations or advice they received about PSA tests from health care professionals.
Among 232,548 men who responded to the questions, nearly 40% reported receiving a PSA test during the timeframe when it was not recommended.
Having a single personal doctor was linked to the discussion of both advantages and disadvantages of PSA tests, but also a recommendation to receive a PSA test.
The results do not suggest that interpersonal continuity with one regular doctor is not important. Quite the contrary, these results reinforce the power of that relationship
The team says the patient-physician relationship and trust in one’s physician is critical in providing care, but the responsibility falls to physicians to provide the best high-quality care.
The study is published in Frontiers in Medicine. One author of the study is Arch G. Mainous III, Ph.D.
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