Family physicians' knowledge of commonly overused treatments and tests

Abstract

Purpose: In 2010, several primary care physician organizations drafted the "Promoting Good Stewardship in Clinical Practice" list for family medicine to advance the appropriate use of 5 commonly ordered treatments and tests. The goal was to achieve excellent patient care while appropriately conserving health care resources. The purpose of this study was to assess knowledge regarding the appropriate use of these treatments and tests among the memberships of the Uniformed Services Academy of Family Physicians (USAFP) and the Council of Academic Family Medicine (CAFM).

Methods: An online, cross-sectional survey of all family physician members of the USAFP and the CAFM was conducted. The survey consisted of 5 clinical cases administered as part of a larger omnibus CAFM Educational Research Alliance survey and a separate USAFP membership survey. The primary outcome was correct answers to clinical scenarios.

Results: The response rate was 11% (n = 236 of 2165) for members of USAFP and 47% (n = 519 of 1099) for CAFM members, with an overall response rate of 23% (n = 755 of 3264). Overall, respondents answered 78% of cases correctly (USAFP 79%, CAFM 78%; no significant difference). In rank order, respondents were most likely to answer the Papanicolaou test question correctly (90.1%), followed by the low-back pain (86.7%), the dual-energy X-ray absorptiometry screening (85.4%), the sinusitis (66.5%), and the cardiac screening questions (61.4%).

Conclusion: Among the family physicians surveyed, knowledge about the appropriate use of commonly overused tests and treatments was high. Two clinical scenarios (sinusitis and cardiac screening) demonstrate areas where further education could improve care and reduce costs.

Keywords: Cardiovascular Diseases; Diagnostic Techniques and Procedures; Low-Back Pain; Prevention and Control; Primary Health Care; Sinusitis.