Taxonomy I Part VIII (Pediatrics-Adolescent Medicine)

(23 April 2006 22:10)

NATIONAL PROJECT ON THE COMMUNITY BENEFITS

OF FAMILY MEDICINE RESIDENCY PROGRAMS

CUMULATIVE QUESTIONNAIRE RESPONSES

Taxonomy Section I Part X

Pediatrics/Adolescent Medicine

SD I.13w(1.1) (new) Does your residency provide the following kinds of specialty care: w. Pediatrics? Yes __ No __

Yes:

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OHSU Portland

Glasgow

Lexington

OHSU Portland

SD I.13w(1.2) (new) If you do provide pediatrics, are these services provided as normal family medicine center appointments? Yes __ No __

Yes:

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OHSU Portland

SD I.13w(1.3) If you do provide pediatrics, are these services provided during special clinics?  Yes __ No __

If the answer to SD I.13w(1.3) is yes, what is the number of patients seen?  What revenues are generated in each specialty service?

No:

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OHSU Portland

NPCB P2 I.13.2w(SD I.13w(1.4)) Describe the kinds of pediatrics that typically takes place within the family medicine center (whether as normal appointments or during special clinics):

Tyler                            (well child care; circumcision; state-mandated child testing EPSDT growth and development tests; height and weight monitoring; immunizations; school physicals; sports physicals)

Las Vegas                    (well child care; sick child visits; ADHD management; family therapy)

Fresno                          (the full scope)

Springfield                    (well child care; school physicals; otitis; failure to thrive; immunizations and updates; sports medicine; asthma; apnea; cradle cap; thrush)

Glasgow                       (routine pediatric care; autism; ADHD; Kawasaki’s disease; congenital heart disease; pediatric dermatology; behavioral disorders; newborn care; prematurity)

Lexington                     (everything)

OHSU Portland            (well child care; immunizations; pediatric infectious diseases; developmental delay; ADHD; other behavioral problems)

Phase 2 Responses:

Sparrow                       (Well child and infant care; abdominal pain; earaches; developmental and adjustment disorders; failure to thrive; growth problems; ADD management)

Huntsville                      (Birth and development; congenital disease of all types; nutrition assessment; immunizations; childhood diabetes; asthma; all types of infections – otitis media, streptococcal; pharyngitis)

Ventura                        (all forms of pediatrics – well-child, acute processes)

Long Beach                  (full spectrum – well-child exams at all levels; episodic sick visits of every kind)

U Penn                         (normal appointments)

Crozer-Keystone          (newborn to adolescence; immunizations; growth evaluation; some ADHD treatment)

Jefferson                       (full range of pediatrics)

McKeesport                 (all routine child care; immunizations; lead screening; parental guidance; two pediatricians work in the family medicine center)

Oahu                            (primary care pediatrics; well-child; colds; initial evaluation of short stature)

Shadyside                     (all normal well-child care; sick visits; some behavioral health; enhancing services for ADD; adolescents with mental health problems; primary care mental health services; a behavioral scientist and pediatrician come ½ day a week for behavioral problems)

Johnstown                    (well child care of all ages; developmental screening; within our pediatric cardiology clinic, we co-manage the chronically ill with pediatric specialists at the Children’s Hospital of Pittsburgh)

Altoona                        (normal appointments and half days scheduled for well child exams; complete care for all problems)

St Margaret                  (mostly well-child care and acute care visits)

Fairfax                          (normal newborn care; acute minor illnesses; pediatric inpatient care)

NPCB P2 I.13.2w(1) For what conditions would your residency program refer patients to pediatricians? What is the expected wait time before the patient is seen?

Sparrow                       (Seldom; cannot remember the last time)

Huntsville                      (congenital cardiac murmur; significantly enlarged tonsils; congenital kidney disease; genetic syndrome; Type I diabetes if management is difficult)

Ventura                        (serious infections; serious chronic disease; special needs children (such as cerebral palsy and cystic fibrosis) usually seen in conjunction with pediatricians)

Long Beach                  (we never do, except to pediatric subspecialists)

U Penn                         (physician specific – 1 day to a month)

Crozer-Keystone          (rarely refer to pediatricians, except for inpatient management, some ADHD evaluation; 2 weeks turnaround)

Jefferson                       (nothing is referred out, except developmental delay, pediatric seizures or pediatric HIV; 3 months for developmental peds)

McKeesport                 (only for hospitalization; some developmental delay; ADHD for initial evaluation; psych diagnosis; 1 month, except inpatient is immediate)

Oahu                            (never to general pediatricians, only to subspecialists for diabetic or significant stature issues; congenital anomalies; eating disorders)

Shadyside                     (very complex cases, such as liver disease, severe congenital heart disease; some complex, non-resolving problems)

Johnstown                    (referrals are never made to a general pediatricians; we will refer to a pediatric subspecialist, or a pediatrician with skills in treating children with special needs; sometimes for a child abuse exam)

Altoona                        (recalcitrant behavior problems or cancer patients in an advanced disease stage, needing pediatric input; referrals are very rare, maybe once a year; no estimate of wait time, since it is such a rare occurrence)

St Margaret                  (developmental delays, although it takes 4-6 months to get a referrals; acute illness requiring hospitalization is taken care of immediately)

Fairfax                          (no referrals to general pediatrics; referrals are made for congenital heart disease to a pediatric cardiologist (but no echoes), to pediatric pulmonologists for sever asthma, BPD, to pediatric nephrologists for ureteral reflux or congenital reflux, to a pediatric neurologist for severe ADD, seizure disorders or normal surgery, to a pediatric rheumatologist for juvenile rheumatoid arthritis, to a developmental pediatrician on issues of developmental delay; referrals are seen in less than a week)

SD I.13x(1.1) (new) Does your residency provide the following kinds of specialty care: x. Adolescent Medicine? Yes __ No __

Yes:

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OHSU Portland

SD I.13x(1.2) (new) If you do provide adolescent medicine, are these services provided as normal family medicine center appointments? Yes __ No __

Yes:

Tyler

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OHSU Portland

SD I.13x(1.3) If you do provide adolescent medicine, are these services provided during special clinics? Yes __ No __

If the answer to SD I.13x(1.3) is yes, what is the number of patients seen?  What revenues are generated in each specialty service?

Yes:

Tyler                            (adolescent medical clinic held every other week; 10 patients per month; $900 month/revenues)

No:

Las Vegas

Fresno

Springfield

Glasgow

Lexington

OHSU Portland

SD I.13x(1.4) Describe the kinds of adolescent medicine that typically takes place within the family medicine center (whether as normal appointments or during special clinics):

Tyler                            (BIHEADSSS Questionnaire; one on one counseling for troubled adolescents; full medical evaluations, as needed; eating disorder management)

Las Vegas                    (well child risk management; contraceptive care; pre-natal care; family therapy; management of psychological disorders; sexual trauma; referrals from date rape; victims of crime compensation (sexual assault clinics); evaluating substance abuse; evaluating high risk behaviors; post-partum depression; adolescents in violent environments)

Fresno                          (full scope)

Springfield                    (preventative patient education; contraception; exercise; smoking cessation; counseling on peer pressure)

Glasgow                       (depression; obesity; oppositional defiant disorder; ADHD; counseling)

Lexington                     (sports physicals; health maintenance; lifestyle)

OHSU Portland            (substance abuse; ADHD; family planning; pregnancy; infectious diseases; STDs)

Phase 2 Responses:

Sparrow                       (puberty counseling; birth control; STD management; participatory counseling; adolescent developmental issues; drug abuse and safety; sexuality)

Huntsville                      (Birth control; growth and development; counseling on drugs, tobacco, alcohol, abstinence; PAP smears; sports physicals; evaluation for orthopaedic scoliosis)

Ventura                        (kids with difficulty in school; pregnancy; drug-related issues; behavioral problems; adolescent gynecology)

Long Beach                  (well visits; contraceptive counseling and management; sports medicine physicals; sick visits)

U Penn                         (normal appointments)

Crozer-Keystone          (adolescent development; education and prevention; counseling; school medicine programs)

Jefferson                       (all primary care)

McKeesport                 (evaluation of medical and psychosocial concerns; child abuse and neglect)

Oahu                            (all primary care)

Shadyside                     (all normal well-child care; sick visits; some behavioral health; enhancing services for ADD; adolescents with mental health problems; primary care mental health services; a behavioral scientist and pediatrician come ½ day a week for behavioral problems)

Johnstown                    (drivers physicals; sports medicine; depression; eating disorders; adolescent mental health; sexual identity; family upheavals; birth control)

Altoona                        (normal appointments for the full range of problems)

St Margaret                  (well child care; school and camp physicals; sports physicals; acute illnesses; some counseling issues; gynecologic care for adolescent females)

Fairfax                          (routine care; pre-participation sports physicals; discussions about high risk behaviors; adolescent gynecology; adolescent adjustment and mental health)

*NPCB P2 I.13.2x(1) For what conditions would your residency program refer patients to adolescent medicine specialists? What is the expected wait time before the patient is seen?

Sparrow                       (difficult mental health issues; developmental, adjustment issues)

Huntsville                      (no conditions are referred out)

Ventura                        (extreme cases of any of the above conditions that are non-responsive; suicidal children go to behavioral scientists)

Long Beach                  (no conditions are referred out)

U Penn                         (physician specific – same day to one month)

Crozer-Keystone          (ADHD and conduct disorders; one month wait)

Jefferson                       (nothing is referred out, except some adolescent psych)

McKeesport                 (severe mental health problems at mental health units or Children’s Hospital; for pediatrics and adolescent/pediatric subspecialists there is a long wait)

Oahu                            (rarely; eating disorders are referred to psychiatrists and psychologists)

Shadyside                     (no conditions are referred out)

Johnstown                    (no conditions are referred out)

Altoona                        (any referral would require the patient to go out of town; the wait time could be months)

St Margaret                  (for complex psychosocial issues and behavior problems; four weeks wait for adolescent clinics)

Fairfax                          (behavioral issues may be referred to adolescent psychiatrists or behaviorists; no other consultations are made)

*NPCB P2 I.  Does your residency program manage the following disorders for your family medicine center patients either in the inpatient of outpatient settings (or both)?

a) well child care?                              Yes __ No __

Yes:

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.  Does your residency program manage the following disorders for your family medicine center patients either in the inpatient of outpatient settings (or both)?

b) immunizations?                              Yes __ No__

Yes:

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.  Does your residency program manage the following disorders for your family medicine center patients either in the inpatient of outpatient settings (or both)?

c) coordination of special needs?      Yes __ No __

Yes:

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.  Does your residency program manage the following disorders for your family medicine center patients either in the inpatient of outpatient settings (or both)?

d) behavioral issues?                         Yes __ No __

Yes:

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.  Does your residency program manage the following disorders for your family medicine center patients either in the inpatient of outpatient settings (or both)?

e) pre-participation physicals?          Yes __ No __

Yes:

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.  Does your residency program manage the following disorders for your family medicine center patients either in the inpatient of outpatient settings (or both)?

f) adolescent health counseling (pregnancy counseling, sexuality, eating disorders, etc.)                                                            Yes __ No __

Yes:

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

*NPCB P2 I.8(2) Does your program utilize screening and surveillance procedures consistent with professional guidelines for growth and physical development of children and adolescents? Yes __ No __

Yes:

Santa Rosa

Reading

York

Lebanon

Billings

Monroeville

Beaver

Latrobe

Erie

Lawton

Last Updated (04 September 2006 17:18)