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Acad Med. 2009 Mar;84(3):396-401. doi: 10.1097/ACM.0b013e3181970bb9.

Characteristics of medicine-pediatrics practices: results from the national ambulatory medical care survey.

Author information

1
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts 02215, USA. rfortuna@post.harvard.edu

Abstract

BACKGROUND:

Combined medicine-pediatrics (med-peds) training has existed for 40 years, yet little is known about national med-peds practices. A more comprehensive understanding of med-peds practices is important to inform medical students and guide evolving curricula and accreditation standards.

METHOD:

The authors used data from the National Ambulatory Medical Care Survey from 2000 to 2006 to characterize the age distribution and types of visits seen by med-peds, internal medicine, pediatric, and family physicians.

RESULTS:

Forty-three percent of visits to med-peds physicians were from children < or = 18 years of age. Compared with family physicians, med-peds physicians saw a higher proportion of infants and toddlers < or = 2 years of age (21.0% versus 3.7%; P = .002) and children < or = 18 years of age (42.9% versus 15.5%; P = .002), but they treated fewer adults age 65 or older (13.8% versus 21.3%; P = .013). Compared with internists, med-peds physicians saw a greater percentage of visits from adults 19 to 64 years of age (75.8% versus 61.2%) and fewer visits from patients age 65 or older (24.2% versus 38.8%; P = .006). Med-peds physicians, like family physicians and pediatricians, most commonly treated patients for acute problems and reported high levels of continuity of care for patients-pediatric (93.6%) and adult (94.6%).

CONCLUSIONS:

Med-peds physicians care for a considerable proportion of pediatric patients while maintaining high levels of continuity of care for adult and pediatric patients. Within their practices, med-peds physicians treat a larger percentage of pediatric patients than do family physicians, but they see a smaller percentage of elderly patients.

PMID:
19240455
DOI:
10.1097/ACM.0b013e3181970bb9
[Indexed for MEDLINE]

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