Doctor Survey Results- Eastern Shore of Maryland- Summer 2010

Survey delivered to 150 doctors- completed and returned by 40 practicing in the following eastern shore counties of Maryland- Wicomico, Worcester, Dorchester, Somerset, Talbot, Caroline, Queen Anne and Kent.

*KEY- Correct answers (if applicable) are in blue font

Which best describes your current medical practice?

Response

Percent

Private Practice

51.4%

Group Practice

40.5%

Hospital/Academic Setting

8.1%

How many patients with tick bites have you seen in the past 12 months? Response

Zero

5.3%

1-10

28.9%

11-20

13.2%

21-30

13.2%

31-40

7.9%

41-50

7.9%

more than 50

10.5%

more than 100

13.2%

How many patients with Lyme disease have you seen in the past 12 months? Response

Zero

5.3%

1-10

60.5%

11-20

18.4%

21-30

5.3%

31-40

2.6%

41-50

5.3%

more than 50

2.6%

more than 100

0.0%

How many tests have you ordered for Lyme disease in the past 12 months?

Do you routinely provide information (handouts) to patients about Lyme disease?

Response

yes

25.6%

no

74.4%

Response

PercentResponse

Count

Zero

12.8%

5

1-10

25.6%

10

11-20

7.7%

3

21-30

10.3%

4

31-40

7.7%

3

41-50

12.8%

5

more than 50

15.4%

6

more than 100

7.7%

3

Other

Show Responses

1

Do you discuss prevention methods or Lyme disease with your patients?

Always 7.7%

Usually 41.0%

Seldom 17.9%

Only when approached 30.8%

Never 2.6%

Do you think the physical exam finding of erythema migrans rash alone is sufficent to establish the diagnosis of Lyme disease?

Response

Yes

40.5%

No

48.6%

uncertain

10.8%

If you diagnose one of your patient with Lyme disease, the____________

pathogen is responsible.

Response

PercentResponse

Count

Babesia microti

2.7%

1

Lxodes damini

2.7%

1

Borrelia burgdorferi

97.3%

36

Bartonella quintana

0.0%

0

Babesia duncani

0.0%

0

Testing for Lyme disease in an untreated patient is most appropriate__________.

Response

At the time of tick attachment

3.0%

Three days after the tick is removed

3.0%

Four weeks after a tick bite

72.7%

All of the above

15.2%

None of the above

6.1%

*NOTE- All of the following, with the exception of "Goiter", are possible signs or symptoms of Lyme disease.

Possible signs and symptoms of Lyme disease include

Response

PercentResponse

Count

Fever

97.5%

39

Third-degree heart block

62.5%

25

Fatigue

92.5%

37

Migratory arthralgias

92.5%

37

Conjunctivitis

35.0%

14

Bell's palsy

77.5%

31

Bursae, tendon, bone and muscle pain

75.0%

30

Goiter

5.0%

2

Cranial neuropathies

72.5%

29

Meningitis

65.0%

26

Arthritis

90.0%

36

How do you usually treat an asymptomatic patient with a recent tick bite (within a week) who had no lab teasting preformed to date?

Response

PercentResponse

Count

Query patient about the length of tick attachment, type of tick and degree of engorgement

71.9%

23

test patient and wait for results to determine appropriate action to take

3.1%

1

prescribe antibiotics as a prevenative measure

34.4%

11

wait to see if symptoms develop, then test and treat

28.1%

9

have patient return in 4 weeks for follow-up

18.8%

6

Testing for Lyme disease in an untreated patient is most appropriate__________.

Response

PercentResponse

Count

At the time of tick attachment

2.9%

1

Three days after the tick is removed

2.9%

1

Four weeks after a tick bite

73.5%

25

All of the above

14.7%

5

None of the above

5.9%

2

Do you treat (or recommend treatment ) for a patient with an erythema migrans rash and negative Lyme test?

Response

PercentResponse

CountNever

9.4%3Seldom

3.1%1Usually

28.1%9Always

59.4%19

How often do you teset( or refer patients for testing) for tick-borne coinfections?

Response

PercentResponse

Count

Never

2.8%

1

Seldom

36.1%

13

Usually

33.3%

12

Always

27.8%

10

What tick borne infections have you tested for (or refferred to others for testing) in symptomatic patients with a history of a tick bite?

Response

PercentResponse

Count

Rocky Mountain Spotted Fever

62.9%

22

Babesiosis

51.4%

18

STARI

2.9%

1

Mycoplasma

5.7%

2

Lyme

91.4%

32

Anaplasmosis

8.6%

3

Ehrlichiosis

74.3%

26

Baronella

5.7%

2

None

0.0%

0

If Patient remains symptomatic after inital treatment for Lyme disease, or relapses, what course of action do you generally take?

Response

PercentResponse

Count

Re-treat

24.0%

6

Re-test and re-treat if positive

48.0%

12

Consider alternate diagnosis

56.0%

14

Treat symptomatically

20.0%

5

Where do you generally get your information about Lyme disease?

Response

PercentResponse

Count

Internet

41.0%

16

Medical Journals

82.1%

32

Colleagues

38.5%

15

DHMH

12.8%

5

CDC

33.3%

13