title: Physicians' preparedness for bioterrorism and other public health priorities.
abstract: OBJECTIVE
  Potential bioterrorism challenges policy makers to balance competing public health priorities. Earlier surveys showed low physician bioterrorism preparedness but did not assess physicians' general public health preparedness, compare the preparedness of emergency and primary care physicians, or assess temporal trends.
  
  
  METHODS
  This was a national, cross-sectional, random-sample survey conducted in 2003.
  
  
  RESULTS
  Overall, 744 of 1,200 eligible physicians responded (response rate, 62%). Of these, 58% of emergency physician respondents and 48% of primary care physician respondents reported having learned a lot about responding to bioterror since September 11, 2001 (p < 0.01). However, only 43% of emergency physicians and 21% of primary care physicians agreed they are generally "well prepared to play a role in responding to a bioterror attack" (p < 0.001). Beliefs about balancing public health priorities were similar among emergency and primary care respondents. Seventy-eight percent of respondents believed that local health care systems need to be prepared for bioterrorism, and 92% believed that local health care systems need to be prepared for natural epidemics. By contrast, only 23% and 46% of respondents reported that their local health care systems are well prepared for bioterrorism and natural epidemics, respectively. Meanwhile, 77% agreed that "influenza is a greater threat to public health than bioterrorism," and 21% reported that bioterrorism preparedness efforts are diverting resources from more important public health problems.
  
  
  CONCLUSIONS
  In 2003, most emergency and primary care physicians reported that they and their local health care systems were not yet well prepared to respond to a bioterror attack, and many believed that more resources should go toward preparing for natural epidemics. These findings highlight the importance of expanding bioterrorism preparedness efforts to improve the public health system more broadly.
authors.affiliation: MacLean Center for Clinical Medical Ethics, and Division of General Internal Medicine, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637, USA. galexand@uchicago.edu
authors.forename: G Caleb
authors.initials: GC
authors.lastname: Alexander
authors.forename: G Luke
authors.initials: GL
authors.lastname: Larkin
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Wynia
mesh_terms: D001291:Attitude of Health Personnel; D023482:Bioterrorism; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004635:Emergency Medicine; D005260:Female; D006292:Health Priorities; D006801:Humans; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D011320:Primary Health Care; D011634:Public Health; D011795:Surveys and Questionnaires; D014481:United States