Should Our Well-Child Care System Be Redesigned?

A National Survey of Pediatricians

This study used a mail survey to assess physician perceptions of the delivery of well-child care for children ages 0–5 in the United States. The survey measured pediatrician attitudes and behaviors about who should provide various elements of care and the format and location of well-child visits. A nationally representative sample of 502 eligible physicians responded to the survey. Logistic regression models and maximum likelihood ordered logistic regression models were used to statistically analyze the survey data.

Key Findings:

  • Ninety-seven percent of pediatricians reported a positive rating of the current well-child care provision system.
  • More than half of pediatricians felt that anticipatory guidance, developmental screening and psychosocial screening should be provided by a nonphysician.
  • A quarter of pediatricians stated that some well-child services could be provided in alternate locations outside of the doctor's office and there was much support for the provision of anticipatory guidance by phone and e-mail.
  • Physician age was the only characteristic that showed consistent variation with the pediatricians' responses.