Opinions of Rhode Island Physicians on Automated Multiphasic Screening

Abstract

A UTOMATED multiphasic screening exists today as a limited and controversial part of health care in the United States. The Rhode Island multiphasic screening (MPS) program was started in 1968 as one of four demonstration projects in health screening initiated by the Public Health Service. Its operation was based on the acceptance of two concepts: (a) that periodic health assessment does have value and (b) if chronic disease is uncovered early its subsequent course may be altered (1). Recently, automated multiphasic screening has been cited as a potentially useful technique in the delivery of health care quite apart from its original concept as a device for preventive medicine in detecting the early stages of diseases through mass screening of the population. It has been proposed as a means of combating the rising costs of medical care and the shortage of skilled medical manpower (2), functioning as an aid to private physicians in examining their patients, as a point of entry for the undoctored into the health care system, as an efficient method of prehospitalization or other required medical physical examination, and as a means of colleeting a data base for personal medical records or epidemiologic surveys (3). Whether automated multiphasic screening can prove to be of value in meeting these goals is an important question that is not easily answered. Existing automated health testing centers have not been functioning long enough, nor has the scope of their operations been extensive enough, to evaluate fully their effectiveness in detecting disease in the population and their yield in terms of cost benefits (3a). Equally as important as the scientific and economic value of multiphasic screening is the acceptance o? its concepts and application in medical care by the medical profession. A recent survey by Bates and Mulinare (4) concludes that although physicians have an unmet need for screening tests, their attitudes toward these tests appear to be highly ambivalent. In Rhode Island, physician opinion concerning the MPS center at the Rhode Island Hospital in Providence is particularly important for its operation. As the screening program is currently operated, participants are not accepted unless they have a resource (that is, a private physician or clinic) to which the test data can be sent for interpretation as part of a complete health examination. Thus the program is not an end in itself but is completely useless to the participant unless the result is interpreted to him by his physician. Physician opinion is also important when planMr. von Oeyen is with the division of biological and medical sciences, Brown University, and the department of ambulatory care and community medicine, Rhode Island Hospital. This study was supported in part by Public Health Service grant No. PH 110-68. Tearsheet requests to Paul von Oeyen, Department of Ambulatory Care and Community Medicine, Rhode Island Hospital, Providence, R.I. 02903.