Addressing Posttraumatic Stress Disorder in Primary Care
Post-traumatic stress disorder (PTSD) is an undertreated psychological condition prevalent among service members and veterans. Members of the military community often raise mental health concerns in primary care settings. However, many primary care physicians (PCPs) lack training in PTSD within the military community and may be underprepared to discuss PTSD or trauma with patients.
We assessed a sample of 7,426 PCPs registered with WebMD/Medscape to assess their knowledge of evidence-based PTSD screening and treatment practices, confidence in their abilities to provide clinical PTSD care, and frequency of asking new patients about their military history. Forty-three percent of PCPs reported they very often or always screened for military history and, on average, PCPs answered 41% of the PTSD knowledge items correctly. PCPs who rated their PTSD knowledge higher were more confident and more frequently screened for military history, but did not have higher knowledge scores compared with PCPs with lower self-assessed knowledge. Several PCP characteristics such as sex, years of practice, and practice setting predicted PTSD measures.
Findings suggest that PCPs have gaps in their PTSD knowledge and screening practices. The absence of a meaningful correlation of knowledge scores with PCP self-assessed knowledge or confidence suggests PCPs may not accurately rate their own knowledge. Targeted, evidence-based training on effective practices may promote PTSD clinical knowledge.