Maciek Godycki-Ćwirko, Malgorzata Koziarska-Rosciszewska, Katarzyna Kosiek et al. described an unequal level of performance depending on the preventive procedure and on the targeted population [20]. Some studies have concentrated on attitudes to and involvement in health promotion and lifestyle counselling [21], and the perception of family physicians’ role in modifying behaviour [22]. The reasons for the study results may be found in available incentives. There was no financial incentive specific to any of the groups of physicians since there was one universal payment for intervention regardless of the specialisation of the providers. The type of intervention did not seem to be important since the trend was the same for all the programmes and their combinations. Therefore it may be a feature of the individual physician, related to his/her vocational training and performance. Family physicians provide continuous, general, comprehensive, family and community oriented health care [23, 24]. As a result of their training, as well as their family and community orientation, they may also have a stronger public health orientation than other medical specialists. They may be more efficient than other specialists in leading the incorporation of health goals within the broader public agenda, collaboration with government, encouragement of coalitions, integrated approaches and commitment to evaluation of processes and outcomes in local communities, factors which proved to lead to success in other programmes [25]. Family physicians believe they should advise on prevention and health promotion issues [18, 26], although these tasks should be a part of more comprehensive community-based activities and national policy [27]. The results of this study supported these beliefs and present an argument to develop policies to strengthen the role of the family physician as a cornerstone of a public health oriented health care system. The results also suggest the need for specific educational programmes directed at physicians with different specialisations and for specific incentives for different physicians participating in preventive programmes. The strength of this study was the inclusion of all physicians involved in CVD and COPD prevention programmes. They also would not have been aware of the researchers’ interest in exploring differences in the role of specialisation. A limitation could be the involvement of urban physicians only, although one can assume that in a public health care system with undifferentiated capitation payments a non- urban setting would not alter the results. Another limitation could be a bias as a result of focusing only on two prevention programmes. Again, one could argue that these programmes were the most appropriate to evaluate physicians’ attitude towards prevention, considering the potential health gain related to the prevention in the case of these two particular diseases. Further research on the correlation between the specialty of primary care physicians and the rate of delivery of care they provide is needed. In conclusions: • participation of primary health care providers in preventative programmes and the rates of their delivery of interventions were low despite additional funding; • the correlation between the proportion of physicians with a particular specialisation, involved in CVD and COPD prevention interventions delivery, and the rate of programme accomplishment was the strongest for family physicians; • further assessment of the correlation between the specialisation of primary care physicians and the care they provide may facilitate decisions related to vocational training for primary health care and the implementation of preventative programmes. Acknowledgments The authors wish to thank the President of Lodz for the grant supporting the research performed, the employees of the National Health Fund in Lodz for providing the data and Professor Nigel Mathers for reviewing the manuscript. R e f e r e n c e s 1. Polonski L, Gasior M, Gierlotka M, Zembala M. Epidemiology, treatment and prognosis of acute coronary syndromes at Silesia – PL-ACS register [Polish]. Kardiol Pol 2005; 62: 122-7. 2. Wierzbowska-Drabik K, Kasprzak JD. Management on non-ST-segment elevation acute coronary syndromes. Current ECS recommendations [Polish]. Lek Rodz 2008; 2: 148-61. 3. Zdrojewski T, Wyrzykowski B, Szczech R et al. Epidemiology and prevention of arterial hypertension in Poland [Polish]. Nadcisnienie tetnicze 2005; 14 Suppl 2: 10-16. 4. Sethi A, Arora RR. Ambulatory blood pressure as a predictor of cardiovascular risk. Arch Med Sci 2009; 5: 3-9. 5. National Program for Prevention and Treatment of Cardiovascular Disease in 2006-2008 „POLKARD 2006- 2008” [Polish]. http://www.mz.gov.pl/wwwmz/index?mr =m241614181&ms=416&ml=pl&mi=418&mx=0&mt=&m y=153&ma=07867. Accessed Oct 6, 2008. 6. Maciejewski J. Prevelance of COPD in family physician practice. PhD thesis [Polish]. Warsaw, Institute of Tuberculosis and Pulmonary Diseases, 2007. 7. Bednarek M, Plywaczewski R, Górecka D, et al. Early identification of COPD in smoking inhabitants of Warsaw [Polish]. Pneumonol Alergol Pol 2002; 70: 139-47. 8. Niepsuj G, Kozielski J, Niepsuj K, et al. Chronic obstructive pulmonary disease in Zabrze inhabitants [Polish]. Wiad Lek 2002; 55 Suppl 1: 354-9. 9. Polish Respiratory Society. Recommendations of Polish Respiratory Society on identification and treatment of 212 Arch Med Sci 2, April / 2010