Urologists: Please teach us PCPs about 'zebras'
The specialist must be cognizant of the vast information base required of PCPs, who are masters of nothing, but knowers of all.
Fast-forward to 2007 and a new study about chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) reported at this year's AUA annual meeting. The study, by Clemens et al, found major gaps in the understanding of CP/CPPS among primary care physicians in the United States (see, "PCPs show major gaps in understanding of CP/CPPS," page 1).
I was interested in the authors' finding that the National Institutes of Health classification of prostatitis, which is standard knowledge in urology, was known by about half of respondents to their survey. I am surprised that the figure is that high, and I applaud my colleagues who have reviewed it. Could you imagine a PCP being up to date on all of the NIH classifications? He or she would be quite the "mega doctor" among his or her peers. The specialist must be cognizant of the vast information base required of PCPs, who are masters of nothing, but knowers of all.
I certainly applaud the authors' efforts in exposing this educational gap, but it should come as no surprise to anyone. The authors could have simply looked at the training regimen of the average PCP to discover the paucity of urologic training.
How, then, do we address the knowledge gap?
Education, education, education. This might be accomplished through organized weekend seminars that teach urologic health, through more integration of urology into PCP residency training, or by having AUA work with NIH to further identify gaps in PCPs' knowledge. A quick fix might be for community urologists to call a few of their PCP colleagues and share a couple of clinical pearls. It might help, and it certainly won't hurt. Conversely, PCPs shouldn't hesitate to call local urologists with questions.
The familiar saying holds true here: "Give a man a fish, and you have fed him for today. Teach a man to fish, and you have fed him for a lifetime."
Dr. Rosenberg is medical director of Mid-Michigan Health Centers, a family practice in Jackson, MI. Earlier in his career, he received training as a urologist.
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