Direct observation of counseling on colorectal cancer in rural primary care practices

Edward F. Ellerbeck, Kimberly K. Engelman, Joe Gladden, Michael C. Mosier, G. S. Raju, Jasjit S. Ahluwalia

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


To better understand colorectal cancer (CRC) screening practices in primary care, medical students directly observed physician-patient encounters in 38 physician offices. CRC was discussed with 14% of patients ≥50 years of age; 87% of discussions were initiated by the physician. The rate of discussions varied among the practices from 0% to 41% of office visits. Discussions were more common for new patient visits, with younger patients, and in the 24% of offices that utilized flow sheets. The frequency of CRC discussions in physician offices varies widely. More widespread implementation of simple office systems, such as flow sheets, is needed to improve CRC screening rates.

Original languageEnglish (US)
Article number1610697
Pages (from-to)697-700
Number of pages4
JournalJournal of general internal medicine
Issue number10
StatePublished - 2001
Externally publishedYes

Bibliographical note

Funding Information:
Partial funding for this project was provided through the following grants: The Robert Wood Johnson Foundation Generalist Physicians Faculty Scholars award (#032686, J. S. Ahluwalia); Kansas Academy of Family Physicians (J. Gladden); J. H. Baker Trust of La Crosse, Kansas (J. Gladden); Kansas Association for Medically Underserved (J. Gladden); and Primary Care Physician Edu cation grant from the Kansas Health Foundation.


  • Colorectal cancer
  • Counseling
  • Patient education
  • Primary care physicians
  • Reminder systems
  • Rural communities


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