J. Lane Tanner, M.D, F.A.A.P., Martin T. Stein, M.D., F.A.A.P., Lynn M. Olson, Ph.D. et al.; and Linda Radecki, M.S., Lynn M. Olson, Ph.D., Mary Pat Frintner, M.S.P.H. et al.
J. L. Tanner, M. T. Stein, L. M. Olson et al., "Reflections on Well-Child Care Practice: A National Study of Pediatric Clinicians," Pediatrics, Sept. 2009 124(3):849–57; L. Radecki, L. M. Olson, M. P. Frintner et al., "What Do Families Want from Well-Child Care? Including Parents in the Rethinking Discussion," Pediatrics, Sept. 2009 124(3):858–65.
Commonwealth Fund–supported articles published in the September issue of Pediatrics examine well-child care visits from two perspectives: those of pediatric clinicians and parents. Both groups recognize the need for a greater emphasis on developmental and behavioral issues, as well as the challenge of balancing families’ individual needs with the need to cover the topics recommended in pediatric guidelines.
Well-child care—the cornerstone of preventive pediatrics—has received increasing attention in recent years. While well-child visits have traditionally been associated with activities like immunizations and school physicals, professionals in the field recognize the visits can be a critical vehicle in addressing other important topics, such as developmental and psychosocial issues. As the pediatric community continues to "rethink" well-child care, it is important to consider both parents’ and pediatricians’ expectations and experiences. Two focus group–based studies—one of pediatric clinicians and pediatric nurse practitioners and the other of parents—highlight some common ground.
Pediatric Provider Focus Groups
Parent Focus Groups
Parents and practitioners alike want a greater emphasis placed on behavioral and developmental issues, and both groups recognize the challenge of balancing families’ specific needs with the topics pediatricians are expected to cover in a typical visit—a major challenge for physicians. “The number of recommended health directives for well-child care has far outstripped the time available,” the authors state. Participants in the clinician study endorsed the idea of reorganizing visits according to health and developmental risk and providing longer and more frequent visits for those with greater needs.
The study of pediatric clinicians involved 31 focus groups with 282 pediatricians and 41 pediatric nurse practitioners, conducted between December 2005 and May 2007. The parent study involved 20 focus groups with 101 parents, conducted from September 2005 to July 2006.
Both parents and pediatric clinicians believe well-child care visits should emphasize developmental and behavioral issues, with families playing a key role in setting priorities.