Most physicians willing to serve but unready for bioterrorism

September 09, 2003

A survey of 1,000 physicians found that four out of five were willing to care for victims of a bioterrorist attack, but only one out of five felt well prepared for such a role.

Despite the terrorist attacks of September 11, the anthrax mailings, widespread media coverage and a proliferation of programs to teach physicians about bioterrorist agents, a survey conducted in early 2002 by University of Chicago researchers and published in the September 9, 2003, issue of Health Affairs, found that most doctors did not believe they or their practice were well prepared.

"Two years later we really aren't where we ought to be in terms of readiness to handle the next bioterrorism event, whatever that may be," said co-author Matthew Wynia, M.D., associate professor of medicine at the University of Chicago and director of the American Medical Association's Institute for Ethics. "The good news is that physicians are learning more about this and most are willing to help out. The bad news is that, despite this, they don't yet know what their role is and where they fit in the disaster response system."

The researchers were just as troubled by the 20 percent who were unwilling as by the 80 percent who were unprepared.

"Doctors have a moral obligation to care for the sick," said co-author Caleb Alexander, M.D., an instructor in clinical medicine and associate faculty at the MacLean Center for Clinical Medical Ethics at the University of Chicago.

Risk has traditionally been part of medical care and there have long been statements in professional codes of ethics supporting the duty to treat, yet only 55 percent of the surveyed doctors agreed that physicians have an obligation to care for patients in epidemics even if doing so endangers the physician's health.

Fewer physicians reported a willingness to treat as the authors described scenarios of increased personal risk. Although 80 percent were willing to treat patients with an "unknown but potentially deadly illness," that fell to 40 percent when the question involved a risk of "contracting a deadly illness." It dropped to 33 percent when the virus was specified as smallpox and it was stipulated that the physicians had not first been vaccinated.

Physicians in primary care were more likely to report willingness to treat, as were those who felt well prepared and those who saw it as a professional duty.

"Given the complexities of learning about bioterrorism, the perceived low likelihood of a local attack, and the many competing priorities facing doctors, it might be unrealistic to expect most physicians to learn how to detect and treat even the most likely bioterror agents," noted the authors. "Efforts to strengthen the public health infrastructure and ensure that all physicians understand their role in the emergency response system may be equally important ways of fostering preparedness."

"Furthermore," Alexander added, "this is an opportunity for physicians to rearticulate and reaffirm long-standing ethical principles regarding the duty to treat."

The research was supported by the Institute for Ethics at the AMA and the Robert Wood Johnson Foundation Clinical Scholars Program.
-end-


University of Chicago Medical Center

Related Primary Care Articles from Brightsurf:

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Continuity of English primary care has worsened with GP expansions
A new study published by the British Journal of General Practice has found that patients' abilities to see their preferred GP has fallen greater in English practices that have expanded, compared with those that stayed about the same size.

Primary care office-based vs telemedicine care visits during COVID-19 pandemic
This observational study quantified national changes in the volume, type and content of primary care delivered during the COVID-19 pandemic, especially with regard to office-based visits compared with telemedicine encounters.

Expenditures for primary care may affect how primary care is delivered
This study looks at trends in out-of-pocket and total visit expenditures for visits to primary care physicians.

Primary care clinicians drove increasing use of Medicare's chronic care management codes
To address the problem of care fragmentation for Medicare recipients with multiple chronic conditions, Medicare introduced Chronic Care Management (CCM) in 2015 to reimburse clinicians for care management and coordination.

Primary care at a crossroads: Experts call for change
Primary care providers have experienced a rise in responsibilities with little or no increase in the time they have to get it all done, or reduction in the number of patients assigned to them.

Primary care physicians during the COVID-19 epidemic
Scientists from the University of Geneva has analysed clinical data from more than 1,500 ambulatory patients tested for COVID-19.

The five phases of pandemic care for primary care
The authors present a roadmap for necessary primary care practice transformations to care for patients and communities during the COVID-19 pandemic.

Women almost twice as likely to choose primary care as men
Analysis of osteopathic medical school survey data reveals women are 1.75 times more likely to choose primary care than men, according to a study in The Journal of the American Osteopathic Association.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

Read More: Primary Care News and Primary Care Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.