Chest
Clinical Investigations: CardiologyComparative Knowledge and Practice of Emergency Physicians, Cardiologists, and Primary Care Practitioners Regarding Drug Therapy for Acute Myocardial Infarction
Section snippets
Study Population
This study was conducted nationally in order to obtain a sufficient number of participants from April through September 1995. In the first phase of survey distribution, telephone contact with the program or research director of each of the nation's 104 approved emergency medicine residency training programs30 was attempted to obtain the number of emergency medicine board-eligible or board-certified physicians on each program's faculty. Successful contact was made with 93 (89.4%) of the
Demographic Characteristics of the Physicians
Questionnaires (1,045) were returned by eligible physicians; 564 (54%) came from the emergency medicine faculty group, 481 (46%) came from the nonfaculty group, and 181 came from ineligible physicians; this yielded an estimated eligibility rate of 85% (in both groups) and an overall response rate of 55% among eligible emergency physicians (57.4% of the faculty group and 52.1% of the nonfaculty group). The comparison of the characteristics of the emergency physicians with those of the study
Discussion
Most patients presenting for treatment of acute myocardial infarction (AMI) are treated by emergency physicians in hospital emergency departments.26, 27, 28 This study was undertaken to assess the comparative knowledge and practice of emergency physicians, cardiologists, and primary care practitioners regarding the standard of care for the emergency department drug therapy for AMI. Ayanian et al29 had previously surveyed internists, family practitioners, and cardiologists. Using the same study
Conclusion
Within the context of this study, emergency physicians, on average, have a similar or significantly better knowledge and practice of most short-term pharmacologic interventions in the setting of AMI than cardiologists, and both groups, on average, have a superior knowledge and practice in this area than primary care practitioners. The treatment of patients with AMI, based on evidenced-based medical practice, is one of the quintessential examples of the function and purpose of the emergency
ACKNOWLEDGMENTS
The authors would like to acknowledge John Z. Ayanian, MD, MPP, Department of Health Care Policy, Harvard Medical School, for the use of his study instrument and his contributions to the data analysis and manuscript preparation; Pamela Williams-Russo, MD, MPH, Clinical Epidemiology Unit of the Department of Medicine, Cornell University Medical Center-New York Hospital, for her contributions to data analysis and presentation and manuscript preparation; and Neal Shipley, MD, Center for Emergency
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The survey was distributed directly from and entirely funded by the Department of Emergency Medicine of New York Methodist Hospital, Brooklyn. The statistical analyses and manuscript preparation took place at the Department of Emergency Medicine of New York Methodist Hospital and the Clinical Epidemiology Unit of the Department of Medicine of the Cornell University Medical Center-New York Hospital, New York.
revision accepted July 14, 1997.