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
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