When patients and pediatricians say good-bye in a pediatric resident continuity clinic
J. Serwint and P. Johnson
Department of Pediatrics and Family-Centered Care, Johns Hopkins Hospital, Baltimore, Md, USA.
Pediatric residency programs require a 3-year continuity clinic experience
for residents. To our knowledge, no authors have examined the impact of
termination at the end of the residency among the child, parent, and
pediatrician. This article discusses an exploration that evolved in
response to the questions that third-year pediatric residents asked
concerning how to say good-bye to their primary care patients in the
context of their continuity clinic. The first panel addressed parental and
patient issues, and the second addressed the impact on the pediatrician.
The parents on the panel stated that it was important that they be notified
in advance of their pediatrician's departure, that they believed they had
played an important role in the resident's education, and that they wanted
a voice in the selection of their child's future pediatrician. The
pediatricians on the panel all felt sadness, relief, and guilt as a result
of the termination, but guilt that the family would feel abandoned was the
strongest emotion. Few pediatricians on the panel acknowledged the impact
of the relationship on themselves and the importance of including the
parents in the decision to choose the child's future pediatrician. The
issue of termination needs more deliberate attention in pediatric training
programs. A structured system for teaching residents to manage the
termination process is proposed.
