COMPARATIVE KNOWLEDGE AND PRACTICE OF EMERGENCY PHYSICIANS, CARDIOLOGISTS, AND PRIMARY-CARE PRACTITIONERS REGARDING DRUG-THERAPY FOR ACUTE MYOCARDIAL-INFARCTION

Objectives: This study assesses the knowledge and practice of emergenc y physicians regarding the treatment of acute myocardial infarction (A MI) and compares the results with previously published data on cardiol ogists and primary care practitioners. Background: Debate surrounding the respective roles of emergency physicians, primary care practitione rs, and specialists figures prominently in discussions regarding the n ation's evolving health-care system. Data are lacking about the compar ative knowledge and practice of emergency physicians, cardiologists, a nd primary care practitioners regarding conditions commonly treated by all three groups, eg, AMI. Methods: A survey of 1,045 emergency physi cians, nationally, was conducted in 1995 regarding five short-term pha rmacologic interventions employed for many years in the standard treat ment of AMI. The emergency physicians were questioned about the effect on survival of each intervention and the likelihood that they would p rescribe each intervention. The findings were then compared with previ ously published data on the knowledge and practice of cardiologists an d primary care practitioners obtained in New York and Texas in 1993. I dentical clinical queries and eligibility criteria were employed in al l groups. Results: The responding emergency physicians' knowledge was similar or significantly greater than that of responding cardiologists for the effect on survival of most of the short-term interventions, a nd their practice patterns were similar or significantly better than r esponding cardiologists for all interventions studied. Emergency physi cians and cardiologists had significantly better knowledge and practic e in this area compared with responding primary care practitioners. Co nclusions: For the management of AMI, emergency physicians, on average , have a similar or greater awareness of the effects on survival and s imilar or better practice patterns regarding most acute pharmacologic interventions when compared with those of cardiologists; both groups, on average, have a superior knowledge and practice when compared with primary care practitioners, These results illustrate the importance of emergency medicine and support further consideration of an expanding role for the emergency physician in the nation's evolving health-care system.