Comparison of Knowledge of Perioperative Care in Primary Care Residents Versus Anesthesiology Residents (Clinical Report‪)‬

Primary care physicians (internal medicine and family practice) are often asked to evaluate patients before surgery and prepare them for the procedure. The goal of our study was to examine primary care and anesthesiology resident physicians' knowledge of preoperative evaluation and preparation as well as perioperative changes during anesthesia and surgery. To this end, a questionnaire was sent to primary care resident physicians and anesthesiology resident physicians in our university hospital system. One hundred twenty questionnaires were distributed, and the overall response rate was 50.8%. Although there was agreement between anesthesiology and primary care residents in many of the areas surveyed, differences were observed in questions related to appropriateness of preoperative instructions regarding medications, utility of routine preoperative testing, and identification of expected physiologic changes during anesthesia and surgery. Of the maximum possible 36 points, the mean score for anesthesiology residents (27.55) was higher than the mean scores for primary care residents (21.4 and 20.24 for internal medicine and family practice, respectively), although overall scores were generally lower than expected for both anesthesiology and primary care residents. The level of training of the respondents did not significantly affect the responses. We conclude that primary care resident physicians were knowledgeable about most perioperative care, although some deficiencies were identified when these residents were compared with anesthesiology residents. Surveys such as ours may be used to identify areas of deficiencies that require further education for both groups of residents. The number of people in the USA older than 65 years is expected to increase by 13.3% by 2010 and 53.2% by 2020, as baby boomers age and life expectancies lengthen (1). This increase in the population of older individuals will result in increased surgical workload (2-4) and a resulting need for preoperative preparation. Furthermore, more complex procedures are being increasingly performed on sicker and older patients in the outpatient setting. There is therefore a need for comprehensive preoperative evaluation and preparation to minimize the occurrence of perioperative complications.