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Have professional recommendations and consumer demand altered pediatric practice regarding child development?
C Minkovitz1, M B Mathew, D Strobino
1Department of Population and Family Health Sciences, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA. cminkovi@jhsph.edu
Journal of Urban Health : Bulletin of the New York Academy of Medicine
|December 17, 1998
Summary
Pediatricians often neglect routine developmental screening in newborns, focusing more on safety than developmental or mental health. More experienced doctors feel better equipped to meet parental needs, despite less time with infants.
Area of Science:
- Pediatric Medicine
- Child Development
- Healthcare Provider Practices
Background:
- Growing demand for early childhood development information.
- Professional society recommendations for enhanced developmental care.
- Current pediatric practices in child development are largely unknown.
Purpose of the Study:
- Investigate pediatrician practices regarding children's development.
- Examine differences in provider practices based on years in practice.
- Assess provider satisfaction with developmental care delivery.
Main Methods:
- Self-reported survey of physicians in 30 pediatric practices.
- Physicians categorized into 'in training,' 'recently in practice,' and 'more experienced' groups.
- Comparison of practices and satisfaction across experience levels.
Main Results:
- More experienced pediatricians spend less time in early well-baby visits.
- Routine developmental screening is infrequent; safety assessments are more common.
- Anticipatory guidance covers core topics, but mental health and domestic violence are less discussed.
- Experienced physicians report higher satisfaction with meeting parental needs.
- Common barriers include staff shortages, referral limitations, and time constraints.
Conclusions:
- Most pediatricians do not perform routine developmental screening in the first two months.
- Focus is on safety rather than developmental and mental health concerns for newborns.
- Experienced physicians perceive better ability to meet parental needs and cite fewer organizational barriers.