What Belongs in the Doctor’s Bag?
Eine Befragung erfahrener Hausärztegerman translation / full article
A Survey of Experienced Family Practitioners
Background: Family practitioners (FPs) need to be equipped to provide care for a broad range of medical conditions. However there is no recognized standard which equipment and drugs a doctor’s bag should contain. The aim of this survey was to obtain an evaluation of importance and actual utilization of diagnostic equipment and drugs by experienced FPs.
Methods: This is a cross sectional survey. Based on several recommendations a questionnaire was developed and piloted in a quality circle. The questionnaire was administered to teaching FPs of the Technical University of Munich. Diagnostic equipment and drugs were rated according to their perceived importance (absolutely necessary/can be procured/unnecessary) and utilization (in the last 12 months/in the last 5 years/never).
Results: A total of 66 FP, average age 54 (SD ± 8) years, 83 % male and on average since 19 years (SD ± 8) in practice participated in the survey. Home visits are done daily from 71 %, weekly from 27 % and not at all from 2 %. Out of hour coverage is provided regularly by 80 % and seldom or never by 20 %. The evaluation of importance and actual utilization of drugs and equipment was heterogeneous. High agreement was observed for infusion set (94 % necessary/can be obtained, 83 % in the last 5 years) and morphine i. v. (91 % necessary/can be procured, 83 % in the last 5 years). Similar agreement was observed nitro spray and furosemide. Often actual use within the last 5 years correlated with the estimated importance. Disagreement was observed e. g. for metoprolol i. v. (41 % unnecessary, 61 % not in the last 5 years) and adrenalin i. v. (91 % necessary/can be procured, 50 % not in the last 5 years).
Discussion: The survey was completed by a relevant group of FPs. Agreement of evaluation of importance and utilization of the proposed equipment ranged was variable. Utilization was not a constant predictor for evaluation of importance. Few of the drugs mentioned are possibly indicators of non-adherence to good clinical practice (i. m. non-steroidal analgesics). The equipment stored in a doctor’s bags depends on the range of services they provide, but also on personal experiences and individual preferences. This is a limitation of a recommendation based on a survey of actual utilization. A consensus paper additionally based on epidemiological data of encountered clinical problems would provide be a useful decision aid how to equip a doctor’s bag.