Tympanocentesis for the management of acute otitis media in children: a survey of Canadian pediatricians and family physicians.

OBJECTIVE To evaluate the current knowledge, practice patterns, skills, and attitudes of Canadian pediatricians and family physicians regarding the role of diagnostic tympanocentesis in the management of acute otitis media in children. DESIGN Survey. SETTING AND PARTICIPANTS A self-completion questionnaire was mailed to a random selection of 302 pediatricians and 196 family physicians practicing in hospitals and community settings across Canada in 2002. A second questionnaire was sent to those who did not respond to the first mailing. MAIN OUTCOME MEASURES The demographic features of respondents and their attitudes, beliefs, and behaviors regarding tympanocentesis for acute otitis media were collected via a 2-page questionnaire consisting of open-ended and multiple-choice questions. RESULTS The overall response rate was 56%. Only 4% of pediatricians and family physicians surveyed received training in tympanocentesis, and none currently perform the procedure. Higher proportions of those who learned to perform tympanocentesis graduated from medical school before 1970 and received postgraduate training outside of Canada compared with those who did not learn to perform tympanocentesis. Pediatricians were more likely than family physicians to make referrals to otolaryngologists for tympanocentesis for acute otitis media (62% vs 48%; P = .04). CONCLUSIONS Few Canadian pediatricians and family physicians in our survey learned to perform tympanocentesis, and none currently perform the procedure. It is not clear whether current practices for tympanocentesis in children with acute otitis media are adequate.