[Compliance of family physicians with the recommendations of 'Hearing Impairment' guideline by the Dutch College of General Practitioners in treatment of simulated paper cases of hearing loss].

OBJECTIVE

To assess the extent to which the practice of general practitioners (GPs) in dealing with adult hearing-impaired patients complies with the recommendations in the NHG standard on 'Hardness of hearing', one year after its publication.

DESIGN

Descriptive.

METHOD: Eight paper cases concerning hearing-impaired patients were presented to 10 GPs. The compliance of the GPs' approach with the NHG standard was recorded, and the differences found were motivated by the GPs.

RESULTS

Compliance was low for 'anamnesis' (27%), reasonable for 'supplementary examination'--'audiography' (42%) and 'whispered voice test' (12%)--and 'evaluation' (65%), and high for 'physical examination' ('otoscopy' 82%). Adapted questioning for the purpose of establishing the case history was observed. The questioning was adapted in so far as it took into account the information that had already been obtained. 'Management' gave high scores for 'instruction' (85%) and 'referral' (72%). For mostly practical reasons, the whispered voice test, recommended in the NHG standard was scarcely used (12%) whereas the tuning fork tests, which are not advocated in the NHG standard, were often used (43%).

CONCLUSION

For the aspects 'otoscopy', 'instruction' and 'referral' the GPs' practice reflected the recommendations contained in the NHG standard 'Hardness of hearing'.