Pediatric physiatry in 2000: A survey of practitioners and training programs

Sneed, Raphael C.; May, Warren; Stencel, Christine; Paul, Scott M.

doi:10.1053/apmr.2002.29650

Cited by 14 publications

(17 citation statements)

References 7 publications

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“…This may be because pediatric PM&R is a recent subspecialty and there are large regional variations in the availability of pediatric PM&R physicians. 24,25 The availability of PM&R physicians who specialize in caring for children with TBI may also vary by region.…”

Section: Discussionmentioning

confidence: 99%

Pediatricians' Knowledge, Attitudes, and Behaviors to Screening Children After Complicated Mild TBI: A Survey

Keenan

Bratton

Dixon

2017

Journal of Head Trauma Rehabilitation

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Objective To understand pediatricians’ attitudes, knowledge and behaviors about the care of children with complicated mild traumatic brain injury (TBI). Setting and participants 3500 pediatricians randomly selected from the American Medical Association master file. Design Cross-sectional survey Main measures Pediatricians were asked about their attitude toward following children with complicated mild TBI for cognitive and behavioral sequelae; their knowledge of TBI sequelae; and, their usual evaluation and management of children following TBI. Results There were 576 (16.5%) completed responses. Most pediatricians (51%) see one or two patients with complicated mild TBI annually. Most pediatricians do not think that pediatricians are the correct clinician group who should by primarily responsible for following children with complicated mild TBI for cognitive (74%) or behavioral sequelae (54%). Pediatricians report difficulty referring children for cognitive (56%) and behavioral (48%) specialty services. Pediatricians have good knowledge of short-term complications of complicated mild TBI. Conclusion Pediatricians do not think they are the correct clinical group to primarily care for children after hospitalization for complicated mild TBI; yet, other clinicians are frequently not accessible. Pediatricians need educational and referral support to provide surveillance for injury sequelae in this group of children.

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Section: Discussionmentioning

confidence: 99%

Pediatricians' Knowledge, Attitudes, and Behaviors to Screening Children After Complicated Mild TBI: A Survey

Keenan

Bratton

Dixon

2017

Journal of Head Trauma Rehabilitation

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“…At the turn of the millennium, a research survey sounded the alarm about the lack of providers of PRM. At that time, when 14 states had no pediatric physiatrists practicing within their borders, combined programs in Physical Medicine and Rehabilitation (PM&R) and Pediatrics (then the only way to train for the field) had decreased from a peak of 21 (1997) to 7 (2000) [5].…”

Section: Case Scenariosmentioning

confidence: 99%

“…The number of PM&R training programs that included 6 months or more of preparation in pediatric rehabilitation fell nearly 8‐fold from 15 of 60 (25%) in 1989 to 2 of 82 (2%) in 2000. The percentage of PM&R training programs with a pediatric focus decreased by a factor of 12 [5]. Thus, most physiatrists graduating from PM&R residency programs have little knowledge of how to care for children with disabilities.…”

Section: Case Scenariosmentioning

confidence: 99%

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To Train or Not to Train: Admission of Pediatricians into Pediatric Rehabilitation Medicine Fellowships

Spierre

Rinaldi

2018

PM&R

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“…We previously surveyed the training of pediatricians as follows: pediatricians' general training in meeting the therapy and DME needs for CSHCN, 1 how practicing pediatricians meet these needs, 2 and the availability of specialists in pediatric rehabilitation medicine. 3 Information from the first study, 1 along with information from others [4][5][6][7][8][9][10][11] that suggest a lack of training in these areas, subsequently prompted us to submit a resolution to the American Academy of Pediatrics (AAP) 2000 Annual Chapter Forum regarding the need for greater training in these areas. This resolution was adopted.…”

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confidence: 99%

Policy Versus Practice: Comparison of Prescribing Therapy and Durable Medical Equipment in Medical and Educational Settings

Sneed

May

Stencel³

2004

Pediatrics

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ABSTRACT. Objective. The American Academy of Pediatrics (AAP) has promoted pediatrician involvement in the care of children with special health care needs (CSHCN), including the prescription and/or supervision of therapies and durable medical equipment (DME) for children in both medical and educational settings, such as schools and early intervention programs. Through this survey, we attempted to quantify objectively how pediatricians direct and coordinate therapy and DME for CSHCN and how these efforts correlate with AAP recommendations.Methods. A survey was mailed to a random sample of 500 physicians listed in the AAP directory, resulting in a final sample of 217 responding physicians who indicated that they provide services to CSHCN. Results of the survey were reported as proportions, means with standard deviations, or medians with interquartile range. Comparisons of proportions among certain subgroups of interest were made using Fisher exact tests.Results. The most recent AAP policy revision addressing the role of physicians in prescribing therapy services for children with motor disabilities appeared in Pediatrics 1996. It listed 6 key items that should be part of a therapy prescription: diagnosis, precautions, type, frequency, anticipated goals (educators may prefer the term "objectives"), and duration. The policy addressed and emphasized the need for what may be additional objectives, namely regular communication between all parties involved, ongoing supervision and reevaluation of the program and problem, and awareness of other community resources for possible referrals. Except for providing a diagnosis, the majority of surveyed pediatricians do not regularly comply with AAP policy recommendations on prescribing therapies and DME in medical and educational settings. Physicians who were trained before 1980 tend to follow AAP recommendations more closely than later graduates. Decreasing involvement of private outpatient pediatricians in coordinating and supervising CSHCNs care was noted. Furthermore, the majority is willing to defer decisions about treatment and goals to nonphysician health care providers (NPHCPs) and, in some cases, even equipment vendors. More than two thirds of the respondents indicated that they would sign a prescription for therapy without their previous initiation if it had been initiated by a therapist. Likewise, most respondents said that they would sign a wheelchair prescription sent to them by a therapist. Few expressed confidence in determining the appropriateness of leg brace (orthosis) prescriptions and arm/hand brace prescriptions. The majority of survey participants said that they give open-ended length of time (no limits under 1 year) on prescriptions for therapy services as part of school-based programs. However, patients' conditions and their therapeutic or equipment needs may change during the school year. Because open-ended prescriptions do not require periodic renewal, they do not provide opportunities for periodic feedback that helps to ensure that the pediatrician is...

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Pediatric physiatry in 2000: A survey of practitioners and training programs

Cited by 14 publications

References 7 publications

Pediatricians' Knowledge, Attitudes, and Behaviors to Screening Children After Complicated Mild TBI: A Survey

Pediatricians' Knowledge, Attitudes, and Behaviors to Screening Children After Complicated Mild TBI: A Survey

To Train or Not to Train: Admission of Pediatricians into Pediatric Rehabilitation Medicine Fellowships

Policy Versus Practice: Comparison of Prescribing Therapy and Durable Medical Equipment in Medical and Educational Settings

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