The therapeutic space and doctor-parent relationship in paediatrics: trainees' experiences and perspectives

To explore paediatric trainees' experiences and perspectives regarding interactions and relationships between physicians and patients' parents.

Email survey was sent to AAP Section of Pediatric Trainees members. Trainees were asked about 40 interactions with parents as well as perceived benefits/risks and potential influences. Analysis of associations between variables and perspectives/experiences used chi-square and Fisher exact.

Three hundred and seventy surveys were completed. Respondents participated in a median of nine interactions (IQR 7-13; range 0-37): 99.7% participated in at least one; 52% in 5-10; 41% in >10. 50% reported refusing to participate in at least one interaction following parental request; 8% refused 5-10; 1% refused >10. Electronic communication/social media domain had highest refusals and most interactions respondents believed should never be allowed. 94% agreed that interactions may be beneficial to providers: 75% identified at least one benefit; 86% one risk. Respondents who are parents or female reported increased interactions.

A variety of interactions with patient's parents are common amongst paediatric trainees, who identify risks and benefits. Disagreements relative to acceptability of certain interactions points to the need for additional research. A reflective educational approach, rather than a prescriptive one, may help trainees better manage these relationships.