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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 (AAFP).

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 do not.

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.

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