PEDIATRICS Vol. 94 No. 3 September 1994, pp. 284-290
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Young, P. C.
Right arrow Articles by Schork, M. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Young, P. C.
Right arrow Articles by Schork, M. A.

The Role of the Primary Care Physician in the Care of Children with Serious Heart Disease

Paul C. Young MD1, Yu Shyr PhD2, and M. Anthony Schork PhD2

1 The Division of General Pediatrics, Department of Pediatrics, The University of Utah School of Medicine, Salt Lake City, Utah; The Division of Pediatric Cardiology, The C. S. Mott Children's Hospital, The University of Michigan Medical Center, Ann Arbor, Michigan
2 The Department of Biostatistics, School of Public Health, The University of Michigan, Ann Arbor, Michigan

Objective. To determine the roles of primary care physicians and specialists in the medical care of children with serious heart disease.

Setting. Pediatric Cardiology Division; Tertiary Care Children's Hospital.

Subjects. Convenience sample of parents, primary care physicians, and pediatric cardiologists of 92 children with serious heart disease.

Design. Questionnaire study; questionnaires based on 16 medical care needs, encompassing basic primary care services, care specific to the child's heart disease and general issues related to chronic illness.

Results. All children had a primary care physician (PCP), and both they and the parents (P) reported high utilization of PCP for basic primary care services. However, there was little involvement of PCP in providing care for virtually any aspect of the child's heart disease. Parents expressed a low level of confidence in the ability of PCP in general or their child's own PCP to meet many of their child's medical care needs. Both PCP and pediatric cardiologists (PC) were significantly more likely than parents to see a role for PCP in providing for care specific to the heart disease as well as more general issues related to chronic illness. PC and PCP generally agreed about the role PCP should play, although PC saw a bigger role for PCP in providing advice about the child's activity than PCP themselves did. PC were less likely to see the PCP as able to follow the child for long term complications than PCP did. PC were more likely than PCP to believe that PCP were too busy or were inadequately reimbursed to care for children with serious heart disease. Only about one-third of parents reported discussing psychosocial, family, economic, or genetic issues with any provider, and PCP were rarely involved in these aspects of chronic illness.

Conclusions. Primary care physicians do not take an active role in managing either the condition-specific or the more general aspects of this serious chronic childhood illness. With appropriate information and support from their specialist colleagues primary care physicians could provide much of the care for this group of children. Generalists and specialists are both responsible for educating and influencing parents about the role primary care physicians can play in caring for children with serious chronic illness.

Submitted on October 11, 1993
Accepted on February 1, 1994




This article has been cited by other articles:


Home page
 PediatricsHome page
J. Stevens, K. J. Kelleher, W. Gardner, D. Chisolm, J. McGeehan, K. Pajer, and L. Buchanan
Trial of Computerized Screening for Adolescent Behavioral Concerns
Pediatrics, June 1, 2008; 121(6): 1099 - 1105.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
C. J. Stille, T. J. McLaughlin, W. A. Primack, K. M. Mazor, and R. C. Wasserman
Determinants and Impact of Generalist-Specialist Communication About Pediatric Outpatient Referrals
Pediatrics, October 1, 2006; 118(4): 1341 - 1349.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
C. J. Stille, A. Jerant, D. Bell, D. Meltzer, and J. G. Elmore
Coordinating Care across Diseases, Settings, and Clinicians: A Key Role for the Generalist in Practice
Ann Intern Med, April 19, 2005; 142(8): 700 - 708.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
C. J. Stille, W. A. Primack, and J. A. Savageau
Generalist-Subspecialist Communication for Children With Chronic Conditions: A Regional Physician Survey
Pediatrics, December 1, 2003; 112(6): 1314 - 1320.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
M. R. Miller, C. B. Forrest, and J. S. Kan
Parental Preferences for Primary and Specialty Care Collaboration in the Management of Teenagers With Congenital Heart Disease
Pediatrics, August 1, 2000; 106(2): 264 - 269.
[Abstract] [Full Text]

Home page
 PediatricsHome page
H. T. Ireys and J. J. Perry
Development and Evaluation of a Satisfaction Scale for Parents of Children With Special Health Care Needs
Pediatrics, November 1, 1999; 104(5): 1182 - 1191.
[Abstract] [Full Text]