Pediatricians No. 1 for Primary Care for Teens

Major Finding: Between 2000 and 2006, the proportion of visits to general pediatricians by adolescents jumped from 38% to 53%.

Data Source: National Ambulatory Medical Care Surveys conducted by the CDC's National Center for Health Statistics.

Disclosures: This study was funded by a grant from the American Board of Pediatrics Foundation. The authors reported no conflicts of interest.

Pediatricians are the No. 1 primary care providers to U.S. adolescents for the first time, according to the results of a survey.

New data reveal that between 2000 and 2006, the proportion of visits to general pediatricians by adolescents (aged 11-17 years) jumped from 38% to 53%, the investigators reported (J. Pediatr. 2010 March 15 [doi:10.1016/j.jpeds.2010.01.003]).

“Previously it had been the case that this age group had a majority of visits to family physicians or internists,” noted Dr. Gary L. Freed and his associates at the University of Michigan, Ann Arbor, and the research committee of the American Board of Pediatrics.

The reasons for the steady, upward shift could be due to a series of demographic trends in the United States, most notably the impact of aging Americans in society, said Dr. Freed.

The number of visits made by all children—from infancy to adulthood—to general pediatricians continues to grow as well. Overall, the percentage of nonsurgical physician office visits that children aged 0-17 years made to general pediatricians rose to 71%.

This is a 10% increase since 1996.

“Because a growing proportion of the population in the United States is in the adult and elder age range, it follows that family physicians, who care for patients across the life course, would have similar growing proportions of their patient panels at the expense of pediatric patients.” As a result, there are fewer family physicians who are performing obstetrics, which affects the number of newborns entering their practices, said Dr. Freed.

There also may be financial implications as to why internists and family physicians are seeing fewer child patients, as Medicare reimbursement rates for the elderly are higher than Medicaid reimbursement rates for pediatric patients, Dr. Freed noted.

In addition, there have been concerns of an actual or imminent shortage of primary care physicians for adults and the elderly, which may drive some family physicians and internists to focus exclusively on those age ranges (JAMA 2009;301:1920-2).

Researchers examined data from the National Ambulatory Medical Care Surveys (NAMCS). The surveys, which used a physician-patient encounter (doctor's visit) as a sampling unit, were conducted between 1980 and 2006 by the Centers for Disease Control and Prevention's National Center for Health Statistics. During the years studied, the total number of samples ranged from 20,760 to 71,594.

Physicians across 15 specialties were examined: family practice, osteopathy, internal medicine, pediatrics, general surgery, obstetrics and gynecology, orthopedic surgery, cardiovascular diseases, dermatology, urology, psychiatry, neurology, ophthalmology, otolaryngology, and a category containing all the other specialties.

The NAMCS then divided the physician specialties into four subcategories: pediatric generalists, pediatric specialists, nonpediatric generalists, and nonpediatric specialists.

The trend of more and more children seeking care from pediatricians (as opposed to nonpediatric generalists and nonpediatric specialists) is likely to continue as long as the elderly remain America's “fasting growing age range,” wrote Dr. Freed.

Major Finding: Between 2000 and 2006, the proportion of visits to general pediatricians by adolescents jumped from 38% to 53%.

Data Source: National Ambulatory Medical Care Surveys conducted by the CDC's National Center for Health Statistics.

Disclosures: This study was funded by a grant from the American Board of Pediatrics Foundation. The authors reported no conflicts of interest.

Pediatricians are the No. 1 primary care providers to U.S. adolescents for the first time, according to the results of a survey.

New data reveal that between 2000 and 2006, the proportion of visits to general pediatricians by adolescents (aged 11-17 years) jumped from 38% to 53%, the investigators reported (J. Pediatr. 2010 March 15 [doi:10.1016/j.jpeds.2010.01.003]).

“Previously it had been the case that this age group had a majority of visits to family physicians or internists,” noted Dr. Gary L. Freed and his associates at the University of Michigan, Ann Arbor, and the research committee of the American Board of Pediatrics.

The reasons for the steady, upward shift could be due to a series of demographic trends in the United States, most notably the impact of aging Americans in society, said Dr. Freed.

The number of visits made by all children—from infancy to adulthood—to general pediatricians continues to grow as well. Overall, the percentage of nonsurgical physician office visits that children aged 0-17 years made to general pediatricians rose to 71%.

This is a 10% increase since 1996.

“Because a growing proportion of the population in the United States is in the adult and elder age range, it follows that family physicians, who care for patients across the life course, would have similar growing proportions of their patient panels at the expense of pediatric patients.” As a result, there are fewer family physicians who are performing obstetrics, which affects the number of newborns entering their practices, said Dr. Freed.

There also may be financial implications as to why internists and family physicians are seeing fewer child patients, as Medicare reimbursement rates for the elderly are higher than Medicaid reimbursement rates for pediatric patients, Dr. Freed noted.

In addition, there have been concerns of an actual or imminent shortage of primary care physicians for adults and the elderly, which may drive some family physicians and internists to focus exclusively on those age ranges (JAMA 2009;301:1920-2).

Researchers examined data from the National Ambulatory Medical Care Surveys (NAMCS). The surveys, which used a physician-patient encounter (doctor's visit) as a sampling unit, were conducted between 1980 and 2006 by the Centers for Disease Control and Prevention's National Center for Health Statistics. During the years studied, the total number of samples ranged from 20,760 to 71,594.

Physicians across 15 specialties were examined: family practice, osteopathy, internal medicine, pediatrics, general surgery, obstetrics and gynecology, orthopedic surgery, cardiovascular diseases, dermatology, urology, psychiatry, neurology, ophthalmology, otolaryngology, and a category containing all the other specialties.

The NAMCS then divided the physician specialties into four subcategories: pediatric generalists, pediatric specialists, nonpediatric generalists, and nonpediatric specialists.

The trend of more and more children seeking care from pediatricians (as opposed to nonpediatric generalists and nonpediatric specialists) is likely to continue as long as the elderly remain America's “fasting growing age range,” wrote Dr. Freed.

Major Finding: Between 2000 and 2006, the proportion of visits to general pediatricians by adolescents jumped from 38% to 53%.

Data Source: National Ambulatory Medical Care Surveys conducted by the CDC's National Center for Health Statistics.

Disclosures: This study was funded by a grant from the American Board of Pediatrics Foundation. The authors reported no conflicts of interest.

Pediatricians are the No. 1 primary care providers to U.S. adolescents for the first time, according to the results of a survey.

New data reveal that between 2000 and 2006, the proportion of visits to general pediatricians by adolescents (aged 11-17 years) jumped from 38% to 53%, the investigators reported (J. Pediatr. 2010 March 15 [doi:10.1016/j.jpeds.2010.01.003]).

“Previously it had been the case that this age group had a majority of visits to family physicians or internists,” noted Dr. Gary L. Freed and his associates at the University of Michigan, Ann Arbor, and the research committee of the American Board of Pediatrics.

The reasons for the steady, upward shift could be due to a series of demographic trends in the United States, most notably the impact of aging Americans in society, said Dr. Freed.

The number of visits made by all children—from infancy to adulthood—to general pediatricians continues to grow as well. Overall, the percentage of nonsurgical physician office visits that children aged 0-17 years made to general pediatricians rose to 71%.

This is a 10% increase since 1996.

“Because a growing proportion of the population in the United States is in the adult and elder age range, it follows that family physicians, who care for patients across the life course, would have similar growing proportions of their patient panels at the expense of pediatric patients.” As a result, there are fewer family physicians who are performing obstetrics, which affects the number of newborns entering their practices, said Dr. Freed.

There also may be financial implications as to why internists and family physicians are seeing fewer child patients, as Medicare reimbursement rates for the elderly are higher than Medicaid reimbursement rates for pediatric patients, Dr. Freed noted.

In addition, there have been concerns of an actual or imminent shortage of primary care physicians for adults and the elderly, which may drive some family physicians and internists to focus exclusively on those age ranges (JAMA 2009;301:1920-2).

Researchers examined data from the National Ambulatory Medical Care Surveys (NAMCS). The surveys, which used a physician-patient encounter (doctor's visit) as a sampling unit, were conducted between 1980 and 2006 by the Centers for Disease Control and Prevention's National Center for Health Statistics. During the years studied, the total number of samples ranged from 20,760 to 71,594.

Physicians across 15 specialties were examined: family practice, osteopathy, internal medicine, pediatrics, general surgery, obstetrics and gynecology, orthopedic surgery, cardiovascular diseases, dermatology, urology, psychiatry, neurology, ophthalmology, otolaryngology, and a category containing all the other specialties.

The NAMCS then divided the physician specialties into four subcategories: pediatric generalists, pediatric specialists, nonpediatric generalists, and nonpediatric specialists.

The trend of more and more children seeking care from pediatricians (as opposed to nonpediatric generalists and nonpediatric specialists) is likely to continue as long as the elderly remain America's “fasting growing age range,” wrote Dr. Freed.