RESUMO
OBJECTIVES: To determine pediatricians' practices, attitudes, and barriers regarding screening for and treatment of pediatric dyslipidemias in 9- to 11-year-olds and 17- to 21-year-olds. STUDY DESIGN: American Academy of Pediatrics (AAP) 2013-2014 Periodic Survey of a national, randomly selected sample of 1627 practicing AAP physicians. Pediatricians' responses were described and modeled. RESULTS: Of 614 (38%) respondents who met eligibility criteria, less than half (46%) were moderately/very knowledgeable about the 2008 AAP cholesterol statement; fewer were well-informed about 2011 National Heart, Lung, and Blood Institute Guidelines or 2007 US Preventive Service Task Force review (both 26%). Despite published recommendations, universal screening was not routine: 68% reported they never/rarely/sometimes screened healthy 9- to 11-year-olds. In contrast, more providers usually/most/all of the time screened based on family cardiovascular history (61%) and obesity (82%). Screening 17- to 21-year-olds was more common in all categories (P?
Assuntos
Dislipidemias/diagnóstico , Dislipidemias/terapia , Programas de Rastreamento/estatística & dados numéricos , Pediatras , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Adulto , Atitude do Pessoal de Saúde , Criança , Aconselhamento/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Fidelidade a Diretrizes , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Estilo de Vida , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Fatores de Risco , Inquéritos e Questionários , Estados UnidosRESUMO
OBJECTIVE: To examine trends in pediatricians working part-time and residents seeking part-time work and to examine associated characteristics. STUDY DESIGN: The American Academy of Pediatrics (AAP) Periodic Survey of Fellows and the AAP Annual Survey of Graduating Residents were used to examine part-time employment. Fourteen periodic surveys were combined with an overall response rate of 57%. Part-time percentages were compared for surveys conducted from 2006-2009 and 2010-2013. The AAP Annual Surveys of Graduating Residents (combined response rate = 60%) from 2006-2009 were compared with 2010-2013 surveys for residents seeking and obtaining part-time positions following training. Multivariable logistic regression models identified characteristics associated with part-time work. RESULTS: Comparable percentages of pediatricians worked part-time in 2006-2009 (23%) and 2010-2013 (23%). There was similarly no statistically significant difference in residents seeking part-time work (30%-28%), and there was a slight decline in residents accepting part-time work (16%-13%, aOR .75, 95% CI .56-.96). Increases in working part-time were not found for any subgroups examined. Women consistently were more likely than men to work part-time (35% vs 9%), but they showed different patterns of part-time work across age. Women in their 40s (40%) were more likely than other women (33%) and men in their 60s (20%) were more likely than other men (5%) to work part-time. CONCLUSIONS: There has been a levelling off in the number of pediatricians working part-time and residents seeking part-time work. Overall, women remain more likely to work part-time, although 1 in 5 men over 60 work part-time.
Assuntos
Pediatria/estatística & dados numéricos , Médicos , Padrões de Prática Médica/tendências , Adulto , Idoso , Coleta de Dados , Emprego , Feminino , Humanos , Internato e Residência , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pediatria/organização & administração , Médicas/estatística & dados numéricos , Distribuição por Sexo , Sociedades Médicas , Estados Unidos , Recursos HumanosRESUMO
OBJECTIVES: To compare satisfaction with specialty care by primary care pediatricians (PCPs), perceived barriers to care, and adequacy of specialist supply. STUDY DESIGN: A survey of U.S. pediatricians was conducted in 2007. PCPs were asked about satisfaction with specialty care for their patients, as well as supply of specific pediatric subspecialists. Responses of rural and nonrural PCPs were compared regarding 10 potential barriers to care. RESULTS: Most PCPs are satisfied with the quality of subspecialty care. However, they were not satisfied with wait times for appointments, and the availability of many pediatric medical subspecialties and several pediatric surgical specialties. Rural PCPs were significantly more likely to report these shortages compared with nonrural pediatricians; these included 9 of the 18 medical and 5 of the 7 surgical specialties. In addition to wait times for appointments, PCPs reported that subspecialists' nonparticipation in health insurance plans and lack of acceptance of uninsured patients were also barriers to obtaining subspecialty care for their patients. CONCLUSIONS: PCPs provide valuable insight into access to the pediatric subspecialty workforce. This survey of PCPs raises significant concerns about the adequacy of children's access to pediatric subspecialists, especially in rural communities.
Assuntos
Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Pediatria/estatística & dados numéricos , Médicos/provisão & distribuição , Encaminhamento e Consulta/estatística & dados numéricos , Especialização/estatística & dados numéricos , Atitude do Pessoal de Saúde , Criança , Coleta de Dados , Feminino , Acessibilidade aos Serviços de Saúde/organização & administração , Humanos , Seguro Saúde/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pediatria/normas , Padrões de Prática Médica/estatística & dados numéricos , Qualidade da Assistência à Saúde , Serviços de Saúde Rural/provisão & distribuição , Estados Unidos , Listas de EsperaRESUMO
OBJECTIVE: To compare the job search experience and career plans of medicine-pediatrics (med-peds) and pediatric residents. STUDY DESIGN: Annual surveys of graduating med-peds and pediatric residents were compared from 2003 and 2004. RESULTS: The survey response rates were 58% for med-peds residents (n = 427) and 61% for pediatric residents (n = 611). Pediatric residents were more likely to be female or an International Medical Graduate. The groups were equally satisfied with their career choice and had equivalent debt. Med-peds residents were more likely to seek and accept generalist and hospitalist positions. Pediatric residents were more likely to seek subspecialty careers and research opportunities. More than 94% of med-peds residents expected to care for pediatric patients. Among residents seeking generalist positions, med-peds residents sent half as many applications to get the same number of interviews and offers as pediatric residents, were more likely to be offered their most desired position, and were more likely to accept a position in a rural area/small town. Med-peds residents had substantially greater starting salaries as hospitalists or generalists compared with pediatric residents. CONCLUSION: Med-peds and pediatric trainees differ in their career plans, although primary care is their most popular choice. Med-peds- trained physicians have an easier job search experience and greater market valuation.
Assuntos
Escolha da Profissão , Medicina Interna/educação , Internato e Residência , Pediatria/educação , Seleção de Pessoal , Adulto , Bolsas de Estudo , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Medicina , Salários e Benefícios , Especialização , Estados UnidosRESUMO
OBJECTIVES: To examine pediatric residents' research experiences during residency and to explore whether residents' attitudes toward research are related to their decision to pursue subspecialty fellowships. STUDY DESIGN: A national random sample of 500 PL-3 pediatric residents completing training in 2001 was surveyed. Responses were obtained from 318 residents (64%). Resident research experiences and perceived competence were compared for residents planning to pursue subspecialty training (34%) and residents who were not (66%). RESULTS: Residents interested in a subspecialty were more likely to have had formal research training (39% vs 27%) and to have assisted on a research project (26% vs 14%) during residency. Upon residency completion, residents in both groups rated their knowledge of most research skills as being fair or poor. A favorable rating toward research was the strongest predictor of whether residents have subspecialty rather than general pediatrics as their future clinical goal (OR=3.7). CONCLUSIONS: Given residents' limited research exposure and the strong association found between residents' research attitudes and their plans to pursue subspecialty training, serious consideration should be given to the possible benefits of research promotion programs, which may lead to increased resident interest in pediatric fellowships and pediatric research.