The impact on families of pediatric resident departure from a continuity clinic practice
J. R. Serwint, B. J. Wasserman and R. G. Chernoff
Department of Pediatrics, Johns Hopkins Children's Center, Baltimore, MD, USA. jserwint@welchlink.welch.jhu.edu
OBJECTIVE: To determine views of parents whose children were reassigned to
new resident pediatricians at a continuity clinic because their previous
pediatricians had completed residency. DESIGN: Cross-sectional survey.
SETTING: Hospital-based resident continuity clinic. PARTICIPANTS: Ninety
parents whose pediatricians were graduating were interviewed from June
through August 1995. RESULTS: Most parents felt they knew their resident
pediatrician well and that the resident knew their child well. Sixty-eight
parents (76%) were sad about the transition, 33 (37%) were angry, 30 (33%)
felt abandoned, and 6 (7%) were relieved. Three fourths of the parents
thought it was very important for the family to be involved in the
reassignment process, yet less than one fifth had been asked their opinion.
Half of the families were experiencing their second or greater transition.
Families undergoing their first, vs second or greater transitions, were
more likely to feel they knew the resident well (P = .01), and that the
resident knew their child well (P = .04). Despite the transitions, 86 (96%)
of families stated they would continue to have their child receive medical
care at the current site because they knew their child would receive good
care. CONCLUSIONS: Strong physician-patient-parent relationships develop
when residents are the pediatric primary care providers. Parents want to be
informed regarding transitions. Pediatricians need to be sensitive to the
impact of transitions and to negotiate with families in choosing their
future pediatrician. These results have implications for other practice
sites where physician turnover occurs.
