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Area of Science:

  • Pain Management
  • Surgical Practice
  • Public Health

Background:

  • Excessive opioid prescriptions contribute to the US opioid epidemic.
  • Limited national guidelines exist for acute pain opioid prescribing.
  • Assessing prescriber self-awareness of practice is crucial.

Purpose of the Study:

  • To investigate podiatric surgeons' ability to accurately assess their opioid prescribing practices relative to average prescribers.
  • To identify potential cognitive biases influencing self-perception of opioid prescribing.

Main Methods:

  • An anonymous online survey with five surgical scenarios was administered to 115 podiatric surgeons.
  • Participants reported their intended opioid prescription quantities and self-rated their practice against the average.
  • Statistical analyses, including ANOVA and linear regression, compared self-reported behavior and perception, controlling for state laws.

Main Results:

  • Less than half of respondents accurately categorized their opioid prescribing habits.
  • No statistically significant differences were found in prescribing amounts between self-reported categories ('less,' 'average,' 'more').
  • A paradoxical effect was observed where those reporting 'more' prescribed least, and 'less' prescribed most.

Conclusions:

  • A cognitive bias, termed a novel effect, influences postoperative opioid prescribing.
  • Podiatric surgeons often lack awareness of their prescribing patterns compared to peers without objective standards or guidelines.
  • This self-awareness gap may contribute to suboptimal opioid prescribing and the ongoing epidemic.