Implementation of a systematic health maintenance protocol in a private practice.

The impact of a policy to introduce a simple health maintenance protocol systematically to all patients belonging to a private practice is reported. Results after 18 months' experience in over 1400 patients indicate that (1) physician compliance was excellent (97% of eligible patients were included, and physician time taken to introduce the protocol at the index visit took less than 4 minutes), and (2) patient acceptance (which varied from procedure to procedure) was good to excellent (minimum acceptance: 77% for sigmoidoscopy; maximum acceptance: 97% for cholesterol screening). For patients seen once, acceptance rates for procedures were generally comparable to prior published performance rates for highly selected patient populations. Integration of a simple health maintenance protocol into routine office care of unselected primary care patients was feasible, effective, and acceptable to patients. Patient refusal was a minor barrier to performance of health maintenance.