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Updated: Aug 4, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Primary care physicians' use of screening echocardiography
A S Bensky1, W Covitz, R H DuRant
1Department of Pediatrics, Brenner Center for Child and Adolescent Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
Insights
Primary care physicians often lack knowledge of cardiology costs and practice patterns, leading to potentially unnecessary echocardiograms for pediatric heart murmurs. Improving this understanding may enhance cost-effectiveness.
Area of Science:
- Pediatric Cardiology
- Health Services Research
Background:
- Echocardiography is a key tool for diagnosing congenital heart disease in children.
- Primary care physicians (PCPs) play a crucial role in initial screening for pediatric heart conditions.
Purpose of the Study:
- To survey PCPs regarding their reasons for ordering echocardiography for pediatric congenital heart disease screening.
- To assess PCP understanding of cardiology service costs and practice patterns.
Main Methods:
- A questionnaire-based survey was distributed to pediatricians and family physicians.
- Data from 466 responding physicians were analyzed.
Main Results:
- Most PCPs underestimate cardiology consultation and echocardiography costs.
- PCPs' decisions to order echocardiograms are influenced by specialist appointment availability and convenience.
- Family physicians were more likely than pediatricians to order echocardiograms for various indications.
Conclusions:
- Enhancing PCP knowledge of cardiology costs and practice patterns can reduce unnecessary echocardiograms.
- Improving access to cardiology referrals may optimize resource utilization.
- Targeted education can improve cost-effectiveness in pediatric cardiac screening.
Objective:
To survey primary care physicians to understand their reasons for using echocardiography to screen for congenital heart disease in children and to assess their understanding of the costs associated with cardiology services.
Design:
A questionnaire.
Participants:
Eight hundred sixty-seven pediatricians and family physicians in our region were surveyed, 494 (57%) responded and 466 were used for the analysis.
Results:
The majority of pediatricians and family physicians in our area do not know the relative costs associated with cardiology consultation and echocardiography. They also believe it likely that a cardiologist will routinely obtain an echocardiogram as part of their evaluation of a child with a murmur, although this is not the case. The availability and convenience of specialist appointments was found to significantly influence the decision to order an echocardiogram. Family physicians were significantly more likely than pediatricians to order an echocardiogram for a variety of clinical indications.
Conclusions:
Improving primary care physicians' knowledge of the costs associated with cardiology services and current cardiology practice patterns, in addition to improving the availability of cardiology referrals, may reduce the number of expensive and unnecessary echocardiograms. echocardiography, heart murmur, congenital heart disease, cost-effectiveness.
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