How did general practitioners protect themselves, their family, and staff during the SARS epidemic in Hong Kong?

Abstract

Context: Severe acute respiratory syndrome (SARS) is a newly emerging infectious disease and how trie frontline community doctors respond to it is not known. Objectives: To explore the impact of SARS on general practitioners (GPs) in Hong Kong. Design: A cross sectional survey. Setting: Community based primary care clinics. Participants: 183 family medicine tutors affiliated with a local university. Postal survey sent to all tutors with a 74.8% response rate. Main outcome measures: Change of clinical behaviour and practices during the epidemic; anxiety level of primary care doctors. Results: All agreed SARS had changed their clinical practices. Significant anxiety was found in family doctors. Three quarters of respondents recalled requesting more investigations while a quarter believed they had over-prescribed antibiotics. GPs who were exposed to SARS or who had worked in high infection districts were less likely to quarantine themselves (10.8% versus 33.3%; p<0.01; 6.5% versus 27.5%; p<0.01 respectively). Exposure to SARS, the infection rates in their working district, and anxiety levels had significant impact on the level of protection or prescribing behaviour. Conclusion: The clinical practice of GPs changed significantly as a result of SARS. Yet, those did not quarantine themselves suggesting other factors may have some part to play. As failure to apply isolation precautions to suspected cases of SARS was one major reason for its spread, a contingency plan from the government to support family doctors is of utmost importance. Interface between private and public sectors are needed in Hong Kong to prepare for any future epidemics.