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Education of rural physicians about breast cancer through an oncology outreach program.

In 1990, the Rural Illinois Cancer Consortium initiated an intervention in the management of breast cancer for all rural hospitals. Regional data from a 12-county area were used to identify issues and develop an intervention emphasis. The data suggested two management issues: eliminate unilateral diagnostic mammography and increase the number of patients that have their tumor staged. The intervention involved seminars to provide feedback to physicians on management of breast cancer patients in the region. A series of personalized mailings emphasizing the intervention message were also deployed. Although data are not yet available to measure the intervention impact, immediate feedback on the interventions was sought through a physician survey and several process measures. The immediate feedback measures were assessed. These measures were the penetration of the rural hospital seminars, physician behavior self-reported by mail survey, and number of inquiries to the Physician Data Query. Each of the nine hospitals held a seminar, and 39 percent of the rural physicians treating breast cancer patients attended. Survey data showed physician behavior change in the desired direction, compared with data from the baseline medical record audit conducted in 1986-87. Intervention feedback was useful in defining the implementation success of the interventions. The outcome evaluation, based on medical record audits, is in progress.