Anemia. Textbook vs practice

Anemia, particularly if mild, is ignored frequently. We conducted a questionnaire survey of 252 physicians and medical students to verify this impression and to explore the reasons for it. A cumulative 40% to 57% depending on the hypothetical patients' circumstances) of respondents chose to investigate anemia only at hemoglobin levels too low for the accepted criteria in female patients; a striking 78% to 89% did so in male patients. Only 54% and 30% knew the correct textbook definition of anemia for women and men, respectively. More importantly, 35% to 60% demonstrated criteria for choosing to investigate anemia were lower than even their own perception of the textbook definition. Little difference existed among the various physician subgroups in their responses. The discrepancy between what physicians do and what they are taught appears to arise from several factors, of which lack of knowledge is only one.