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The Future Pediatrician: Promoting Children's Health and Development |
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From The Commonwealth Fund: Are there more efficient ways to deliver well-child care? Fund vice president Edward Schor believes there are. Read his recent commentary in the Journal of Pediatrics for recommendations on making office visits more productive for children, parents, and providers. These changes, combined with the recognition that social and physical environments play an important role in lifelong health and social competence, has brought increasing focus on the preventive care available to children and their families. Schor believes that the content of preventive care, as well as the training of practitioners, should be guided by a predetermined set of measurable outcomes for well-child care. Strategies to improve preventive care could include individualized care plans; greater use of practice management tools, such as flow sheets and e-mail; team-based care; and standardized data collection through structured screening and other means. Parents concerned about their children's learning, behavior, or development often report that their pediatrician did not adequately address their concerns. "The dissonance between the needs of patients and the capacity of the health care system is even more pronounced for preventive pediatric care and developmental services," the author writes. The failure to individualize care is likely a function of physicians' habits, the time pressures of running a financially viable practice, and the failure to adopt practice systems that have proven effective and efficient, says Schor. To improve the quality of preventive care, Schor recommends regularly measuring a number of child health outcomes, including: physical goals, like treating vision and hearing problems; emotional, social, and cognitive goals, like recognizing and treating developmental delays; and family functioning goals, like detecting the warning signs of child abuse or neglect. The proportion of parents who reported they were asked whether they had concerns about their children's learning, behavior, or development during a pediatric visit ranged from 29% to 56%, according to the National Survey of Child Health.
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