The Physician Survey on the Post-Concussion and Whiplash Syndromes

Authors


Randolph W. Evans, M.D., 1200 Binz #1370, Houston, Texas 77004

Abstract

SYNOPSIS

Background: The post-concussion syndrome (PCS) and whiplash syndrome (WS) have been controversial topics among physician for many decades. There is little Information available on the opinions end practices of physicians.

Method: In June of 1992, we performed a national survey by mail of the four physician groups most Commonly treating these problems. The number of respondents and response rates were as follows: family physicians, 118, 16%; neurologists, 100, 21%; neurosurgeons, 97, 23%; orthopedists, 82, 13%. The survey Instrument contained items on demographics, definitions, causation, prognosis, medico-legal aspects, testing, and treatment.

Results: Only a minority of respondents believe that PCS and WS are clearly defined syndromes. A substantial minority report that psychogenic and litigation factors are most responsible for the Conditions. Most of the physicians believe that PCS and WS have a 3–6 month recovery time. A significant minority Concur that symptoms of the two syndromes resolve when litigation is settled. Most of the physicians order tests to role out pathology although a minority order tests to reassure patients or because of litigation concerns. Only a minority of respondents believe that effective treatments are available. Not surprisingly, a multitude of Conventional and unconventional treatments are sometimes recommended.

Conclusions: Many aspects of PCS end WS are controversial among treating physicians. This Controversy can have a profound impact on the quality and cost of patient care. Ongoing research is required to discover more effective treatments for mild brain injury and chronic pain.

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