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Journal of Primary Care & Community... 2023During the surge of the COVID-19 pandemic, burnout among physicians increased significantly. In the spring of 2023, the COVID national emergency was terminated in the...
OBJECTIVE
During the surge of the COVID-19 pandemic, burnout among physicians increased significantly. In the spring of 2023, the COVID national emergency was terminated in the U.S. To investigate whether provider burnout rates have returned to pre-pandemic levels, the current study compared dimensions of burnout among pediatricians pre- and post-pandemic.
METHOD
As part of 2 separate behavioral health trainings held at a Midwest academic health center in 2019 and virtually in 2023, data on burnout was collected from 52 pediatricians pre-pandemic and 38 pediatricians post-pandemic. Participants completed an online survey during the trainings and responded to items reflecting 3 dimensions of burnout: emotional exhaustion, depersonalization, and personal accomplishment.
RESULTS
There were no statistically significant differences in pre- and post-pandemic burnout amongst pediatricians in terms of total scores, number of pediatricians who met the clinical cutoff for each dimension, number of cutoffs met, or number of providers reporting elevated burnout on at least 1 dimension ( > .05 for all comparisons). Participants were 1.77 times more likely to meet the cutoff for emotional exhaustion post-pandemic than pre-pandemic. Over half of providers met this cutoff post-pandemic, compared to only 35% pre-pandemic.
CONCLUSIONS
While post-pandemic rates of burnout among pediatricians appear to be statistically similar to pre-pandemic levels, there appear to be clinically significant differences in emotional exhaustion between groups. With 63% of the post-pandemic group meeting the cutoff score for at least 1 dimension, it is imperative for the healthcare system to consider ways to mitigate burnout.
Topics: Humans; Pandemics; COVID-19; Depersonalization; Pediatricians; Burnout, Professional; Surveys and Questionnaires
PubMed: 37599442
DOI: 10.1177/21501319231194148 -
Pediatric Annals Jan 2020Leukocytes, or white blood cells, are part of the innate immune system that defends against infectious and foreign agents. In pediatrics, it is important to use... (Review)
Review
Leukocytes, or white blood cells, are part of the innate immune system that defends against infectious and foreign agents. In pediatrics, it is important to use age-specific laboratory values when interpreting results. Infections are the most common cause of leukocytosis or leukopenia in children. Symptoms suggestive of more serious etiologies include persistent fevers, weight loss, bruising, fatigue, and adenopathy. Neutropenia is of special importance in pediatrics due to associations of severe neutropenia with genetic syndromes and overlapping presentations with primary immunodeficiencies. Although the discovery of novel genetic mutations has aided the hematologist/oncologist and the immunologist in managing these conditions, the relationship between clinical phenotype and mutation is still not well known. [Pediatr Ann. 2020;49(1):e17-e26.].
Topics: Child; Humans; Immunologic Deficiency Syndromes; Leukocyte Disorders; Leukocytes; Pediatricians
PubMed: 31930419
DOI: 10.3928/19382359-20191213-01 -
Indian Journal of Pediatrics Apr 2020
Topics: Cardiology; Child; Humans; Pediatricians
PubMed: 32166606
DOI: 10.1007/s12098-020-03266-3 -
Academic Pediatrics Apr 2023Explore relationships between pediatrician characteristics, sacrifices made for career, and career and life satisfaction.
OBJECTIVE
Explore relationships between pediatrician characteristics, sacrifices made for career, and career and life satisfaction.
METHODS
Surveys of early career pediatricians (ECPs) who recently graduated residency (2016-18), as part of the AAP Pediatrician Life and Career Experience Study (PLACES) were administered in 2019. Logistic regression analyzed association of pediatrician characteristics with personal sacrifices (a lot vs some or no sacrifices) made for one's career and whether career was worth the sacrifices made to become a physician, and association of characteristics and sacrifices with overall career and life satisfaction.
RESULTS
Of 918 ECPs in the cohort, 90% responded to the 2019 survey. Seventy-seven percent agreed their career was worth the sacrifices and 40% reported they made a lot of personal sacrifices for their career. In multivariable analysis, female sex was associated with lower odds of viewing career as worth the sacrifices made [adjusted odds ratio [aOR] 0.45; 95% confidence interval [CI], 0.28-0.71], a higher odds of delaying starting a family [aOR 2.25; CI, 1.32-3.86] and making sacrifices in having children for career [aOR 2.60; CI, 1.48-4.58]. Those in fellowship training also reported making more sacrifices related to having children for their career [aOR 1.73; CI, 1.08-2.78]. ECPs who reported making a lot of sacrifices for their career were less likely to be satisfied with their overall career and life.
CONCLUSIONS
Most ECPs believe their sacrifices to become a pediatrician were worth it. Female pediatricians were less likely to feel personal sacrifices were worth it and reported more sacrifices related to having children.
Topics: Child; Humans; Female; Job Satisfaction; Pediatricians; Physicians; Surveys and Questionnaires; Personal Satisfaction; Career Choice
PubMed: 36682450
DOI: 10.1016/j.acap.2023.01.005 -
Pediatrics Feb 2021
Review
Topics: Armed Conflicts; Child; Commerce; Humans; Mass Casualty Incidents; Pediatricians; Physician's Role; Warfare
PubMed: 33208497
DOI: 10.1542/peds.2020-027847 -
Child's Nervous System : ChNS :... Nov 2020
Topics: Deglutition Disorders; Dysarthria; Facial Paralysis; Humans; Neurologists; Pediatricians
PubMed: 31300846
DOI: 10.1007/s00381-019-04290-1 -
European Journal of Pediatrics Dec 2022Evidence-based practice (EBP) significantly improves the quality of healthcare, but its use in community pediatrics has not yet been proven. We aimed to assess how Dutch...
UNLABELLED
Evidence-based practice (EBP) significantly improves the quality of healthcare, but its use in community pediatrics has not yet been proven. We aimed to assess how Dutch community pediatricians use scientific findings and apply evidence-based practice in everyday well-child care. We interviewed a purposive sample of 14 community pediatricians in the Netherlands regarding their professional activities in daily practice, focusing on instances in which their professional knowledge was insufficient to address the issue at hand. We transcribed the interviews verbatim, and coded them using ATLAS.ti software. We structured the information using template analysis. Community pediatricians relied largely on guidelines of their own profession. If these were not sufficient, they first consulted other medical specialists or colleagues, or used different sources that they considered reliable. They only rarely performed an EBP search, and if so, only for somatic problems. For psychosocial problems, they used a strategy of extensive interaction with clients and members of multidisciplinary teams. We identified five barriers to performing an EBP search: (1) a conviction that not every community pediatrician needs to be able to perform an EBP search; (2) a conviction that an EBP search is not suitable for psychosocial problems; (3) lack of confidence in one's own abilities to perform an EBP search; (4) limited access to literature; (5) lack of time.
CONCLUSIONS
Community pediatricians rely on professional guidelines; this indicates a need to keep these up-to-date and user-friendly. Furthermore, pediatricians should be better trained in performing EBP searches, and in working in multidisciplinary teams, especially for psychosocial problems.
WHAT IS KNOWN
• Conducting an evidence-based practice search is considered indispensable to determine the best management of the patient's problem. • Conducting such a search is still considered challenging in many medical disciplines, including pediatrics.
WHAT IS NEW
• There is a need to strengthen skills of community pediatricians to find evidence on psychosocial problems and to present this effectively in multidisciplinary teams. • The pediatricians' broad use of other sources of evidence, like experts and online sources, shows the importance of critical evaluation skills.
Topics: Child; Humans; Child Care; Netherlands; Pediatricians; Referral and Consultation; Evidence-Based Practice
PubMed: 36169713
DOI: 10.1007/s00431-022-04624-3 -
Pediatric Clinics of North America Feb 2023Pediatrics is a specialty that is grounded in advocacy, possibly more than any other field of medicine. Infants, children, and adolescents depend on others to cover... (Review)
Review
Pediatrics is a specialty that is grounded in advocacy, possibly more than any other field of medicine. Infants, children, and adolescents depend on others to cover their basic needs including food, shelter, and education and rely on proxy voices to speak out on their behalf. In this article, we describe the importance of community advocacy in pediatrics, best practices for training pediatricians in community advocacy, and case studies to highlight trainee experiences and demonstrate how community advocacy and community-based participatory research can be incorporated in the career of a pediatrician.
Topics: Adolescent; Infant; Child; Humans; Child Advocacy; Pediatricians; Pediatrics
PubMed: 36402470
DOI: 10.1016/j.pcl.2022.09.009 -
Indian Journal of Pediatrics Apr 2023The increasing prevalence of autism spectrum disorder (ASD) warrants higher levels of clinical attention to optimally manage children with ASD. There is mounting... (Review)
Review
The increasing prevalence of autism spectrum disorder (ASD) warrants higher levels of clinical attention to optimally manage children with ASD. There is mounting evidence that early intervention programs can help improve developmental functioning, maladaptive behaviors, and core ASD symptoms. The most thoroughly investigated and evidence-based therapies have been developmental, behavioral, and educational interventions mediated by either professionals or parents. Other commonly available interventions include speech and language therapy, occupational therapy, and social skills training. Pharmacological interventions, where needed, are used as an adjunct to treat severe problem behaviors and manage medical and psychiatric comorbidities. Complementary or alternative medicine (CAM) approaches have not proven to be of any benefit, and some of them may be harmful to the child. As the child's first point of contact, the pediatrician is well-positioned to effectively guide the families to therapies that are evidence-based and safe and also collaborate with various specialists to provide seamless, coordinated care for these children so as to improve their developmental outcomes and social functioning.
Topics: Child; Humans; Autism Spectrum Disorder; Parents; Pediatricians
PubMed: 36795273
DOI: 10.1007/s12098-023-04476-1 -
Clinical Pediatrics Feb 2022
Topics: COVID-19; Health Policy; Humans; Pediatricians; Pediatrics; Politics
PubMed: 35132904
DOI: 10.1177/00099228221075096