"If you gave physicians a quiz on these guidelines, they'd do very well, so it's not a matter of them not having the knowledge," says Frolkis. "But sometimes, that information just doesn't translate into how things are done in the real world.

"There is a negative incentive for doctors to perform preventative procedures. It's time consuming at a time when we're asked to see more patients in less time. In many cases, these procedures aren't reimbursable. Even with high-risk patients, risk factor assessment is not being performed, and when it is, appropriate counseling isn't being done."

In the study, race, sex, household income and type of medical insurance had no impact on whether patients received cholesterol-lowering drugs. "For a population as demographically diverse as ours, this negative finding was reassuring," says Frolkis.

Co-authors are Stephen J. Zyzanski, Ph.D.; Jonathan M. Schwartz, M.B.A.; and Pamela S. Suhan, R.N., M.B.A.

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Contact: Brian Henry
brianh@heart.org
(214) 706-1135
American Heart Association
31-Aug-1998