PEDIATRICS Vol. 42 No. 5 November 1968, pp. 733-742
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A SURVEY OF ALLIED HEALTH WORKER UTILIZATION IN PEDIATRIC PRACTICE IN MASSACHUSETTS AND IN THE UNITED STATES

Alfred Yankauer M.D.1, John P. Connelly M.D.1, and Jacob J. Feldman Ph.D.1

1 Departments of Maternal and Child Health and Biostatistics, Harvard School of Public Health; Children's Service, Massachusetts General Hospital; and Department of Pediatrics, Harvard Medical School

A questionnaire was mailed to all fellows of the American Academy of Pediatrics in the Commonwealth of Massachusetts and to a 2% random sample of fellows in all other states. The questionnaire inquired into their present utilization of allied health workers in office practice and their opinions on this subject. Ninety percent of the questionnaires were returned. In 70% of the returns the pediatricians were in solo, partnership, association, or group practice. Relative to the national sample, Massachusetts practitioners were more apt to engage in solo practice (regardless of age), spend more time in health supervision, employ more registered nurses and fewer "medical assistants," and delegate fewer specific tasks to allied health workers. For both sets of respondents, clerical and minor technical task delegation was more common than patient care task delegation. The degree of task delegation and the variety of allied health workers employed in a practice were greater in partnership, association, or group practices than in solo practice, but this did not account wholly for the differences between Massachusetts and national sample. A majority of both Massachusetts and national sample respondents expressed opinions favoring delegation to allied health workers of specific patient care tasks related to information seeking, information giving, and counselling, whether or not this was their current practice. In 80% of all respondents the feeling was that increased delegation in general would result in improved and/or more efficient child care. Teachers of pediatrics and hospital-based clinicians favored delegation more strongly than practitioners.

Submitted on February 20, 1968
Accepted on May 5, 1968




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