Family physicians often manage rheumatic diseases but may overlook psychosocial factors and systemic symptoms. While assessments and care plans were generally adequate, diagnostic information gathering needs improvement in primary care settings.
Area of Science:
Primary Care Medicine
Rheumatology
Medical Education
Background:
Family physicians and general practitioners manage most uncomplicated rheumatic disease cases.
Limited data exists on diagnostic information collection and clinical judgment in these primary care practices.
Standardized patients offer a method to evaluate physician performance in real-world settings.
Purpose of the Study:
To evaluate the diagnostic information collection, assessment, and patient care planning abilities of family physicians.
To identify gaps in primary care physician evaluation of patients with uncomplicated rheumatic disease.
To assess the exploration of psychosocial factors and systemic disease by family physicians.
Main Methods:
Twenty-six family physicians at the University of Arizona College of Medicine participated.
Trained standardized patients, with uncomplicated rheumatic disease, engaged in blinded, brief new patient encounters.
Physicians' abilities in assessment, planning, and information collection were evaluated.
Main Results:
Physicians uniformly inquired about the chief complaint (96%) and onset (88%).
Few physicians explored psychosocial impact (4%) or depression (0%).
Systemic disease inquiry (46%) and physical exam components like joint involvement (69%) were frequently omitted.
Adequate assessments (75%) and care plans (nearly 100%) were developed, but diagnostic information gathering showed deficiencies.
Conclusions:
Family physicians demonstrate strengths in developing adequate assessments and care plans for rheumatic diseases.
There are significant opportunities to improve the thoroughness of diagnostic information gathering, including psychosocial and systemic aspects, in primary care.
Further medical education and practice guidelines may enhance comprehensive patient evaluation in rheumatology within primary care settings.
