A Qualitative Analysis of New York City Based Primary Care and Specialty Providers’ Knowledge of 9/11-Related Health Conditions and Health Care Services

Introduction: More than 10 years after 9/11, thousands of directly exposed persons have myriad disaster-related physical and mental health conditions. Previous studies suggest affected persons may not be utilizing any of the health programs that were created expressly to address 9/11-related health conditions due, in part, to a lack of referrals from primary care physicians. Aim: To understand providers' knowledge of 9/11-related medical conditions, views on and referrals to 9/11 health programs, and how best to provide educational resources to providers and patients. Methods: We conducted semi-structured in-depth individual telephone interviews with 20 New York City based primary care and relevant specialty providers. The interviews were recorded, transcribed and inductively opencoded for thematic analysis. Results: Providers were fairly knowledgeable about psychiatric and respiratory conditions commonly associated with 9/11, but less so regarding conditions whose relationships to 9/11 are still under investigation. Most providers considered 9/11 exposure an important part of patients' medical histories, but did not typically screen for exposure, believing patients would self-report exposure or that exposure was no longer relevant. The majority of providers had positive perceptions of the 9/11 programs, though only some had referred their patients. Providers expressed interest in learning more about 9/11-related health programs and conditions. Conclusion: NYC based medical providers are an under-utilized source of referrals to the 9/11 health programs. Furnishing providers with detailed information on program locations, eligibility requirements, services, and advantages along with summaries of 9/11 research and patient educational materials may increase provider referrals to the programs.