Author Affiliations: Center for Health Policy & Leadership, Bastyr University California, San Diego (Dr Oberg); and School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada (Dr Frank).
The recent analysis by Helfand and Mukamal1 of the preventive and health promotion activities of health care workers (HCWs) brings important attention to this topic, but their interpretation of the data seems predetermined and inconsistent with previous findings.
As noted, the Behavioral Risk Factor Surveillance System item “Do you provide direct patient care as part of your routine work?” creates an extremely heterogeneous sample. The authors claim that this workforce, because of higher health literacy and education, should have superior adherence to health-promoting and preventive behaviors (which has indeed been shown repeatedly among physicians).2,3 However, they have not differentiated between HCWs without formal health care training or advanced education and physicians or others with much more training. In addition to the differences in education and income (reported in the second model), there are other meaningful differences among this mixed cohort, including access to health care services, especially preventive services.4
Oberg E, Frank E. Physicians' Health Practices Are Better Than Patients’. JAMA Intern Med. 2013;173(12):1155–1156. doi:10.1001/jamainternmed.2013.6512
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