Autoevaluación de fortalezas, debilidades y confianza de los médicos de atención primaria en el abordaje de enfermedades reumatológicas

Abstract

Background: Rheumatologic diseases are common and frequently managed by primary care physicians. Aim: To assess strengths, weaknesses and self confidence of primary care physicians in the management of rheumatic diseases. Material and methods: A self assessment and anonymous questionnaire was mailed to primary care physicians of two Chilean regions. Using a 10 points Likert scale, they were asked about personal interest, undergraduate training, continuous medical education, availability of medical literature, complementary laboratory tests and consultation with a rheumatologist. Medical skills, knowledge, therapeutic approach and performance of rheumatologic procedures were evaluated under the item confidence. Results: Three hundred forty seven out of 763 physicians (45%) answered the questionnaire. Their age range extended from 25 to 75 years, 59% were male, 58% were Chilean and 74% worked in the Metropolitan region. The worst evaluated parameters were availability of literature with a score of 2.2 +/- 2, access to consultation with a rbeumatologist (3.8 +/- 2.2) and to continuous medical education (4.3 +/- 2.7). Physicians bad a better confidence in their knowledge (6.7 +/- 1.5) and in their therapeutic approach (6.1 +/- 1.5). The worst confidence score was for shoulder injection therapy (3.4 +/- 2.6). Continuous medical education correlated with knowledge but not with clinical skills. Conclusions. Primary care physicians perform a bad assessment of their skills in rheumatology. They have a low level of confidence in their clinical skills to perform rheumatologic procedures. Continuous medical education improves confidence in knowledge but not in skills.