[Symptoms of urinary tract infections in general practice. A comparison of diagnostic criteria and treatment among general practitioners, microbiologists and urologists].
General practitioners' criteria for good clinical practice vary, and it is unknown whether systematic education by specialists could be expected to reduce variation. The aim of this was to describe general practitioners', microbiologists' and urologists' criteria for diagnosis, treatment, and follow-up of women with symptoms of urinary tract infection. Based on these examples, advantages and disadvantages of using specialists as consultants in GPs' peer-group-based CME (continued medical education) are discussed. Three short case vignettes were presented in a questionnaire to GPs, microbiologists and urologists with prechosen choice of diagnostic, treatment, and follow-up strategy. A total of 154 (77%) GPs, 45 (51%) microbiologists, and 54 (61%) urologists answered the questionnaires. There was considerable variation in proposed strategy both within each specialty and between the specialties. Microbiologists, and to some extent urologists, would more often than the GPs treat a 30-year-old woman via telephone advice and prescription, while they more often tended to ask a 10- and 60-year-old woman to come to the clinic for examination. The GPs, more than the other doctor groups, would ask the patients to return for follow-up. Continuous medical education of GPs based on small-group peer discussions and with specialists as consultants in the groups cannot be expected to lead to less variation in choice of medical strategy.
Olesen
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Aarhus Universitet, Forskningsenheden for Almen Medicin.
Ostergaard
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D003718:Denmark; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008829:Microbiology; D010818:Practice Patterns, Physicians'; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D014572:Urology