[Otorhinolaryngological medical care by the general practitioners in rural areas]

In the present study, a survey of otorhinolaryngological medical care by the general practitioner, including the relationship between general practitioners and otorhinolaryngologists in rural areas was carried out. A questionnaire for otorhinolaryngological medical care by the general practitioners was sent to 326 hospitals with less than 100 beds where non-otorhinolaryngological doctors who had graduated from Jichi Medical School were working. Of these hospitals 164 (50.4%) responded. Most respondents said that they had about 3 or 4 patients with otorhinolaryngological disease per month. The distance between most hospitals and the nearest otorhinolaryngologists was within one hour by available transportation facilities. About 70% of the respondents were provided with simple otorhinolaryngological instruments, such as an aural speculum, a nasal speculum and a head mirror. The most frequent otorhinolaryngological diseases which they treated were vertigo, allergic rhinitis and upper respiratory infection including acute tonsillitis and pharyngolaryngitis. Only 10 to 20% of the general practitioners had otorhinolaryngological training. We found several problems in otorhinolaryngological medical care in rural areas. Patients with otorhinolaryngological disease seek otorhinolaryngological care at the nearest medical facility where general practitioners with inadequate otorhinolaryngological experience examine patients with inadequate otorhinolaryngological instruments. Therefore, a close relationship between general practitioners and otorhinolaryngologists should be developed and the quality of otorhinolaryngological medical care should be raised in rural areas.