Update on adolescent health care in pediatric practice

Purpose: To determine current adolescent health fare practices of pediatricians and evaluate whether changes have taken place during the past decade. Methods: A questionnaire completed by 101 pediatricians in 1985 was abbreviated and adapted by the Committee on Youth of Chapter 2, District II of the American Academy of Pediatrics and sent to 1,633 members of the Chapter in June 1993. Results: Forty-three percent of the 436 respondents in 1993 were female, 43% less than or equal to 40 years of age and 53% were in private practice. Most accept new patients greater than or equal to 16 years of age (76%), continue to see patients greater than or equal to 19 years of age (63%), and interview adolescents without their parents(86%). Although between one-third and two-thirds of respondents report having equipment for gynecologic examinations, most indicate they are ''not entirely comfortable'' treating adolescent issues and therefore refer to others for management. Between one-quarter and one-half indicate they are ''very interested'' in learning more about adolescent issues and an additional 40-50% are ''somewhat interested.'' Obstacles to providing adolescent fare include: ''image as a baby doctor'' (65%), fear that parents would object (61%), no separate hours (57%), difficulty in providing confidential care (56%), and difficulty in charging appropriate fees (47%). Females and younger pediatricians are more comfortable with some aspects of gynecologic care and more likely to be satisfied with the adolescent care they are providing. There were few differences between responses in 1993 and 1985. Conclusions: Few of the pediatricians surveyed provide comprehensive care to adolescent patients. Future policy decisions and medical education must respond to these realities in pediatric practice. (C) Society Sot Adolescent Medicine, 1996.