title: Primary care office responses to a stroke scenario.
abstract: OBJECTIVE
  One previous study found that healthlines affiliated with academic neurology programs recommended non-emergent treatment for a hypothetical stroke scenario almost one quarter of the time, which could contribute to patients presenting too late for time dependent stroke therapies. We assessed the treatment advice given in a hypothetical stroke scenario by primary care physician offices across the United States.
  
  
  METHODS
  We obtained a national listing of United States primary care physician offices from Yellowpages.com, and selected a systematic random sample of numbers to call. The respondent answering the phone was presented with a standardized, scripted stroke patient scenario, and asked to choose one of four responses that could be provided (wait for symptom resolution, attempt to schedule an office appointment later in the day, schedule an office visit within two days, call 911 for ambulance transport to a hospital).
  
  
  RESULTS
  Forty-two respondents completed the survey (average age = 43 years; 88% female), with 29% (95% CI 17%-44%) recommending scheduling an appointment later in the day if symptoms do not resolve. The remaining respondents recommended calling 911. When presented with a heart attack scenario, 100% of respondents recommended calling 911.
  
  
  CONCLUSIONS
  Almost one third of the primary care physician offices recommended scheduling an appointment later in the day for a hypothetical stroke case, despite always giving the correct answer of call 911 for a classic heart attack scenario. These results suggest that stroke education with specific emphasis on the need to call 911 may be needed for primary care physician office receptionists.
authors.affiliation: West Virginia University, USA.
authors.forename: Brett
authors.initials: B
authors.lastname: Jarrell
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Davis
authors.forename: John
authors.initials: J
authors.lastname: Coyner
authors.forename: Todd
authors.initials: T
authors.lastname: Crocco
authors.forename: Charles
authors.initials: C
authors.lastname: Whiteman
mesh_terms: D000328:Adult; D001071:Appointments and Schedules; D057210:Delayed Diagnosis / Q000517:prevention & control*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008496:Medical Receptionists / Q000193:education / Q000592:standards; D020380:Needs Assessment; D009819:Office Visits; D011320:Primary Health Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care; D020521:Stroke / Q000175:diagnosis*