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Indian Journal of Pediatrics Jul 2016Primary care pediatricians are often faced with children and families who need more than just a consultation. Pediatricians are also the first point of contact for many... (Review)
Review
Primary care pediatricians are often faced with children and families who need more than just a consultation. Pediatricians are also the first point of contact for many children and families in distress. Hence, the decision of whether to reassure and follow them up or refer them for an evaluation and management to a mental health professional is something all pediatricians find difficult to make. In order to serve their clients well, it is necessary that pediatricians are trained to identify and manage common child psychological/psychiatric problems. They may also be called upon to break bad news, motivate families to seek treatment and motivate children to accept offered treatment. Most training courses in Pediatrics do not offer skills training in counseling, making the transition to real life practice a difficult proposition. This paper focuses on what is counseling, what situations make it necessary for pediatricians to offer counseling, the methods that can be useful and some tips to improve communication, with an emphasis on unique issues in the Indian context. Some techniques that are simple, brief and can be used by pediatricians are discussed in this paper.
Topics: Child; Counseling; Humans; Pediatricians; Primary Health Care; Referral and Consultation
PubMed: 26817463
DOI: 10.1007/s12098-015-1976-z -
Pediatrics Jun 2023From 2019 to 2022, the For Our Children project gathered a team of Chinese and American pediatricians to explore the readiness of the pediatric workforce in each country...
From 2019 to 2022, the For Our Children project gathered a team of Chinese and American pediatricians to explore the readiness of the pediatric workforce in each country to address pressing child health concerns. The teams compared existing data on child health outcomes, the pediatric workforce, and education and combined qualitative and quantitative comparisons centered on themes of effective health care delivery outlined in the World Health Organization Workforce 2030 Report. This article describes key findings about pediatric workload, career satisfaction, and systems to assure competency. We discuss pediatrician accessibility, including geographic distribution, practice locations, trends in pediatric hospitalizations, and payment mechanisms. Pediatric roles differed in the context of each country's child health systems and varied teams. We identified strengths we could learn from one another, such as the US Medical Home Model with continuity of care and robust numbers of skilled clinicians working alongside pediatricians, as well as China's Maternal Child Health system with broad community accessibility and health workers who provide preventive care.In both countries, notable inequities in child health outcomes, evolving epidemiology, and increasing complexity of care require new approaches to the pediatric workforce and education. Although child health systems in the United States and China have significant differences, in both countries, a way forward is to develop a more inclusive and broad view of the child health team to provide truly integrated care that reaches every child. Training competencies must evolve with changing epidemiology as well as changing health system structures and pediatrician roles.
Topics: Humans; Child; United States; Workforce; Delivery of Health Care; Health Workforce; Pediatricians; Patient-Centered Care
PubMed: 37158018
DOI: 10.1542/peds.2022-059143 -
Current Problems in Pediatric and... Feb 2019
Review
Topics: Child; Child Health Services; Child Welfare; Emigrants and Immigrants; Humans; Pediatricians; Physician's Role; Social Control, Formal
PubMed: 30737181
DOI: 10.1016/j.cppeds.2019.01.005 -
Acta Medica Portuguesa Mar 2021
Topics: Humans; Neonatologists; Neonatology; Pediatricians
PubMed: 33971120
DOI: 10.20344/amp.15709 -
Seminars in Pediatric Neurology Dec 2020Inadequate preparation for transition to adult-oriented systems of care leads to gaps in treatment and can result in poor health outcomes for youth with special... (Review)
Review
Inadequate preparation for transition to adult-oriented systems of care leads to gaps in treatment and can result in poor health outcomes for youth with special healthcare needs. Coordination between primary care and specialists must occur at multiple levels of organizations to improve transition for youth with neurological disorders. This review focuses on the transition process from the pediatrician's perspective, highlights common obstacles, addresses the unique needs of youth with intellectual disabilities, reviews relevant guidelines, and discusses emerging transition strategies. Key recommendations include defining the roles of the different healthcare providers and using multidisciplinary collaboration to overcome limited resources.
Topics: Adolescent; Adult; Guidelines as Topic; Health Services Accessibility; Humans; Intellectual Disability; Nervous System Diseases; Pediatricians; Transition to Adult Care; Young Adult
PubMed: 33308518
DOI: 10.1016/j.spen.2020.100854 -
Academic Pediatrics Apr 2019Utilize the unique capabilities of a longitudinal design to 1) examine whether burnout is increasing over time among 2 cohorts of pediatricians, and 2) identify factors...
OBJECTIVE
Utilize the unique capabilities of a longitudinal design to 1) examine whether burnout is increasing over time among 2 cohorts of pediatricians, and 2) identify factors associated with decreased burnout.
METHODS
Data from a national longitudinal study, the American Academy of Pediatrics Pediatrician Life and Career Experience Study, were used to examine self-reported burnout over a 5-year period (2012 to 2016) among 2002 to 2004 and 2009 to 2011 residency graduates (N = 1804). Study participation rates ranged from 94% in 2012 to 85% in 2016. Mixed-effects logistic regression for longitudinal analysis was used to examine burnout over time.
RESULTS
In any given year, between 20% and 35% of study pediatricians reported that they were currently experiencing burnout. Significant increases in burnout over time were found for all participants combined and for each subgroup examined. Several factors were associated with reduced burnout. The largest associations with reduced burnout were found for increased flexibility in work schedule (adjusted odds ratio [aOR], 0.28; 95% confidence interval [CI], 0.22-0.35), decreased work busyness (aOR, 0.28; 95% CI, 0.22-0.36), or a job change (aOR, 0.48; 95% CI, 0.36-0.65).
CONCLUSIONS
Following 5 years of participation in a longitudinal study, more than 1 in 3 early- to mid-career pediatricians reported experiencing burnout. This represents a 75% relative increase in burnout from the start of the study. Specific characteristics of pediatricians' jobs, such as flexible work schedules and busyness of work settings, were most strongly associated with reduced burnout.
Topics: Burnout, Professional; Female; Humans; Logistic Models; Longitudinal Studies; Male; Odds Ratio; Pediatricians; Personnel Staffing and Scheduling; Protective Factors; United States; Workload
PubMed: 30412766
DOI: 10.1016/j.acap.2018.11.006 -
Current Problems in Pediatric and... Jun 2021Despite the urgency of the climate crisis and mounting evidence linking climate change to child health harms, pediatricians do not routinely engage with climate change...
Despite the urgency of the climate crisis and mounting evidence linking climate change to child health harms, pediatricians do not routinely engage with climate change in the office. Each primary care visit offers opportunities to screen for and support children burdened with risks to health that are increasingly intense due to climate change. Routine promotion of healthy behaviors also aligns with some needed-and powerful-solutions to the climate crisis. For some patients, including those engaged in athletics, those with asthma and allergies, or those with complex healthcare needs, preparedness for environmental risks and disasters worsened by climate change is a critical component of disease prevention and management. For all patients, anticipatory guidance topics that are already mainstays of pediatric best practices are related closely to needed guidance to keep children safe and promote health in the setting of compounding risks due to climate change. By considering climate change in routine care, pediatricians will be updating practice to align with evidence-based literature and better serving patients. This article provides a framework for pediatricians to provide climate-informed primary care during the structure of pediatric well child and other visits.
Topics: Child; Climate Change; Delivery of Health Care; Health Promotion; Humans; Pediatricians; Primary Health Care
PubMed: 34244061
DOI: 10.1016/j.cppeds.2021.101027 -
Pediatrics Jan 2023
Topics: Humans; Pediatricians
PubMed: 36537148
DOI: 10.1542/peds.2022-057775 -
Journal of Clinical Immunology Aug 2023
Topics: Humans; Pediatricians
PubMed: 37243917
DOI: 10.1007/s10875-023-01508-5 -
Pediatric Annals Dec 2023
Topics: Humans; Adolescent; Transgender Persons; Gender Identity; Transsexualism; Pediatricians
PubMed: 38049187
DOI: 10.3928/19382359-20231016-01