Docs at Front Line of Terror War.
Are we prepared?
Bioterror: Spotting the Signs continued...
Before 9/11, many physicians were unaware of the signs of
diseases such as anthrax and smallpox -- likely targets for terrorist use.
Experts say that's now changed.
"What happened was that people went from being totally
ignorant of these [bioterror] issues to being informed as to where to get
information," says infectious disease specialist Jon Temte, MD, PhD,
associate professor of family medicine at the University of Wisconsin.
Temte says primary care and emergency room doctors now have
much better access to information about potential bioterrorist agents provided
by organizations such as the CDC and the American Academy of Family Physicians
He says a focus group conducted among physicians six months
before 9/11 showed that many felt they wouldn't recognize the signs of anthrax
or know how to contact the public health department about it. But another
survey six months after 9/11 showed that while some doctors said they might not
be able recognize an isolated anthrax case, they would recognize a cluster of
cases. And they said they knew how to contact the proper authorities.
Temte says those findings also reveal one of the major problems
facing the U.S. healthcare system in addressing bioterrorist threats and other
major public-health concerns.
"We have a pretty well-trained physician force across the
country," Temte tells WebMD. "But the gaps ... have to do with the
perspective we take. Doctors are still oriented to the individual rather than
the community. I think that is a perspective that needs to change."
Bolstering the Front Lines of Healthcare
Temte says hospitals are better prepared for dealing with
disasters than individual physicians because healthcare organizations have to
go through accreditation processes that require disaster training, and doctors
Although no significant, post-9/11 changes have been made to
the emergency management standards all hospitals must meet for accreditation,
some of the language within the standards has been revised based on the
experiences of organizations that responded to the terrorist attack.
The revised standards call for more cooperative planning
between organizations. Those that provide services to nearby areas must pool
information and resources in case of an emergency.
In addition, the AHRQ recently unveiled a new hospital
bioterrorism preparedness tool that healthcare organizations can use as a
checklist to assess their ability to handle potential victims of bioterrorist
attacks and evaluate existing emergency plans.
"In this context of bioterrorism, the hospital and
healthcare providers are the front line," says Helen Burstin, MD, MPH,
director of the center for primary care research at AHRQ. "One thing that
becomes very clear is that in the event of a bioterrorist attack, people will
go to either their local physician's office or emergency room."
"Since they are so clearly part of the picture in a way
that they may not be for other natural disasters, you really need to make sure
that the hospitals are prepared to handle it," Burstin tells WebMD.