Sexually Transmitted Diseases: Management by Urology, Emergency Medicine and Obstetrician/Gynecology Physicians does not Generally Follow CDC Guidelines

Abstract

Aim: This study was designed to determine the practice habits of physicians in reporting and treating sexually transmitted diseases (STDs), which infect an estimated 15 million people each year in the United States. We hypothesize a variance in how STDs are treated among different medical specialties and the rate of adherence to CDC guidelines. Methods: Prospective study querying 125 physicians regarding STD treatment habits. Seven-question surveys were distributed among urology, ob/gyn, and emergency medicine attending and resident physicians. Results: Of the questionnaires circulated, 76 (61%) were completed. Resident physician response (87%) was higher than attending physician response (13%). 100% of EM and 85% of urology doctors administer empiric STD medications based on history and physical exam findings alone, while most obstetrician/gynecologists (62%) wait for positive cultures prior to treatment. Most physicians do not treat partners of the index patient (ob/gyn 69%, Urology 55%, EM 73%). Reasons for not treating partners were varied and included: follow up, allergies, concerns of medicolegal recourse, time, and loss of revenue and office resources. Finally, while most physicians were concerned about follow-up care, there was no consistency in follow up plans. Conclusion: Our study showed physicians vary greatly in treating and managing STDs. Despite published guidelines by the Center for Disease Control (CDC) specifying an appropriate treatment course for the index patient and their partner, the majority of physicians do not follow these CDC guidelines. This may be creating a quality of care problem for millions of American patients affected by STDs annually.