Study objective: To assess emergency physician knowledge of and effect
on clinical practice of the ACEP ''Clinical Policy for Management of
Adult Patients Presenting With a Chief Complaint of Chest Pain, With N
o History of Trauma. Methods: We conducted a written survey of attendi
ng physicians by mail and in person at emergency medicine meetings. Re
sidents were surveyed at their academic departments. The survey recipi
ents were emergency physicians and residents from university, communit
y teaching, urban, and rural hospitals. Results: Of the 338 surveyed p
hysicians, 163 (48%; 95% confidence interval [CI], 43% to 54%) said th
at they were aware of the policy. Fifty-four percent of ACEP members s
aid they were aware of the policy, compared with 24% of nonmembers. Of
the physicians who said they were aware of the policy, 63% did not kn
ow that the policy contains rules. Seventy-one percent of the physicia
ns who were aware of the policy incorrectly believed the policy requir
es treatment with thrombolytic therapy in certain cases of myocardial
infarction. Physicians said they learned about the policy by reading i
t (42%), by word of mouth (16%), or in department/quality-assurance me
etings (13%). Twelve percent of physicians believe the policy has chan
ged their clinical practice. Conclusion: Fewer than half the emergency
physicians we surveyed were aware of the policy. Of the physicians wh
o said they had been aware of the policy, most did not know important
specifics of the policy.