PEDIATRIC PRACTICE IN THE UNITED STATES

Abstract

This is a report of a mail survey undertaken on behalf of the Subcommittee on Pediatric Manpower of the Council on Pediatric Practice of the American Academy of Pediatrics. Its purposes were: (1) to collect information about how practitioners of pediatrics utilize their own time and that of other health workers for the performance of specific tasks carried out in the course of ambulatory pediatric care; (2) to ascertain the degree to which practice characteristics, including task delegation, were related to characteristics of the physician, his practice arrangement and his practice load; and, (3) to sound out general pediatric opinion concerning task delegation in ambulatory pediatric care. The genesis of this survey and its relationship to current health manpower shortages have been discussed elsewhere.1 Prior to this survey no information on a national basis had been available concerning the extent and nature of task delegation in pediatric office practice or the opinions of pediatricians about this subject. Although most American children receive preventive and therapeutic health care from physicians in private office practice, extraordinarily little information about the characteristics of this system of care is available. A structured, precoded questionnaire was designed to collect the desired information. In the summer of 1967, the first version was pretested on 273 Regular Fellows of the Academy of Pediatrics residing in Massachusetts and a 2% random sample of Fellows residing in the other 49 states and the District of Columbia. The results of this major pretest have been described elsewhere. Slight modifications were made in the original version of the questionnaire and the revised version was mailed in the late fall of 1967 to 6,820 Regular Fellows of tile American Academy of Pediatrics residing in the United States.