Adolescent health care: perceptions and needs of the practicing physician

Three hundred thirty-one Indiana physicians practicing general-family medicine (GP-FP), obstetrics-gynecology (OB-GYN), pediatrics (PED), internal medicine (IM), and psychiatry (PSYCH) were surveyed as to their perceptions about adolescent health and their perceived need for specific adolescent services and Continuing Medical Education (CME). Significant differences were noted in all specialty areas that were not accounted for by the sex or age of the physician. The majority of GP-FP and PED reported that adolescents (aged 11-19 years) made up at least 10% of their practice compared to fewer than 5% of IM practices. Fewer than 7% of the respondents had had no training about adolescent medicine; most (47.5%) had received some CME in adolescent medicine. Family planning was the service least likely to be: provided by PED, IM, and PSYCH, (p less than 0.0001); considered serious for these physicians' adolescent patients (p less than 0.0001); and of interest for CME by all physicians (p less than 0.0001). All specialities believed their adolescent patients to be minimally troubled by the most common problems of youth (p less than 0.0001), but did accurately perceive youth as having psychosocial and medical problems. Training about substance abuse, counseling, learning problems, and eating disorders were most desired. Few respondents wanted individualized, in-person training. The implications of these results are discussed.