PEDIATRICS Vol. 52 No. 3 September 1973, pp. 344-351
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PRIVATE PEDIATRIC PRACTICE: PERFORMANCE AND PROBLEMS

Barbara Starfield M.D., M.P.H.1, Henry Seidel M.D.1, Gertrude Carter B.S.1, William Garvin M.D.1, and Johanna Seddon B.S.1

1 Department of Medical Care and Hospitals of The Johns Hopkins University School of Hygiene & Public Health, the Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, and Clinical Program, Columbia Medical Plan, Columbia, Maryland

All 96 physicians in pediatric practice in the Baltimore area were invited to join in a study assessing the quality of health management. The 15 practitioners who participated helped to set the criteria which were modifications of the standards set by the American Academy of Pediatrics. Medical records of 5-year-olds were audited for recording of preventive procedures, throat cultures for suspected pharyngitis, and urine cultures for suspected urinary tract infection. Some procedures were uniformly well performed; the performance of others varied widely. None of the practices had high rates of recording for all procedures. Existing records proved inadequate to assess the sequence of performance of activities and the relationships between problems, diagnostic procedures, responses, and follow-up. Data from questionnaires sent to all 96 physicians indicated that the performance of the 15 participants was probably higher than that which would be obtained if all the practitioners in the area had participated. This study has implications for the way in which peer review activities are organized and carried out.

Submitted on January 11, 1973
Accepted on March 15, 1973




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