# Knowledge and Attitude of Eastern Province Family Physicians Toward Common Orthopedic Surgery Cases

## TL;DR

This study evaluates how well family physicians in Saudi Arabia diagnose and refer common orthopedic cases, finding strengths in some areas but significant gaps in others.

## Contribution

The study identifies specific knowledge gaps among primary care physicians in orthopedic diagnosis and referral practices in the Eastern Province of Saudi Arabia.

## Key findings

- PCPs showed better diagnostic accuracy for knee osteoarthritis and frozen shoulder compared to DDH and scoliosis.
- Most PCPs recommended bed rest for acute low back pain, which contradicts current guidelines.
- Experienced physicians demonstrated higher diagnostic accuracy.

## Abstract

Background

Orthopedic outpatient departments often experience long waiting lists, even though many referred cases do not require specialist evaluation. Referral guidelines were introduced to address unnecessary referrals and have been continuously updated; however, knowledge gaps persist, particularly in pediatric orthopedic cases. This study aims to evaluate the accuracy of diagnoses and referrals made by Primary Health Care Physicians (PCPs) compared to established referral guidelines in the Eastern Province of Saudi Arabia.

Methodology

This cross-sectional study was conducted among family physicians in the Eastern Province using a self-administered questionnaire with clinical scenarios of common orthopedic conditions and multiple-choice options to assess diagnoses, appropriate management, and referral decisions.

Results

Our results showed that PCPs demonstrated better diagnostic accuracy for knee osteoarthritis (OA) and frozen shoulder in comparison to Developmental Hip Dysplasia (DDH) and scoliosis. Most PCPs advised bed rest for acute low back pain, which is against the recommendations. Physicians with greater clinical experience showed more accurate diagnostic skills.

Conclusion

Primary care physicians generally have an acceptable understanding of common orthopedic conditions, such as knee osteoarthritis and frozen shoulder, and have a clear preference for conservative management approaches. However, notable knowledge gaps persist, particularly in DDH. Furthermore, there were gaps in their knowledge of correct management approaches for back pain and scoliosis. Additionally, a considerable portion of participants remain unfamiliar with existing referral guidelines, highlighting the need for enhanced training in orthopedic assessment and appropriate referral practices.