Content and emphasis of well-child visits. Experienced nurse practitioners vs pediatricians
H. Foye, R. Chamberlin and E. Charney
The content and emphasis of well-child visits conducted by nine randomly
selected pediatricians was compared with those of five experienced
pediatric nurse practitioners. Twenty one nurse visits and 43 pediatrician
visits with 1-year-old to 2-year-old children were monitored. The nurses
discussed developmental and child behavior topics in significantly (P less
than .05) greater depth, they asked more open-ended questions, made more
specific recommendations, provided more maternal support, and the parents
spoke a greater proportion of the time during the nurses' visits.
Efficiency (number and depth of topics considered per unit time) of both
groups was similar. Nurse visits were more time-consuming (mean, 25.5 vs
17.6 minutes for pediatricians). A subgroup of four pediatricians conducted
visits much like those of the nurses, scoring as well in less time. The
other five pediatricians conducted shorter visits, with little emphasis on
child development and provided less time for the parent to talk. Overall,
after five years in practice, these nurses were in no way less complete in
child health supervision than a representative sample of pediatricians and
were considerably more comprehensive in their approach than the average
pediatrician.
