Group well-child care.

Well-child care can be a positive influence on parent-child relationships when social, psychological, and emotional health are stressed. Because of its brevity, the traditional well-child visit does not offer adequate opportunities to address these issues. A group format, in which four to six parent-infant pairs meet, changes the character of the child health maintenance visit. Advantages of group visits include increased time for patient education, more active parental participation, greater time for the physician to observe parents and their children, and more reassurance for parents that they and their children are normal. Problems of group visits are those of space and scheduling. Few pediatric offices have ideal space for group visits, so many visits take place in cramped quarters. Siblings can be disruptive to the group and should be excluded. A dedicated receptionist and an efficient nurse are essential if the groups are to run smoothly. Because the visits last one to one-and-one-half hours, only one group visit can be scheduled during a half day. Although parents of varied socioeconomic and cultural backgrounds benefit from group visits, this format appears to be most acceptable to white, middle-class families. The content of group visits is somewhat dependent upon parental questions and concerns; however, the physician must be careful to include important issues that do not usually arise spontaneously. These topics usually include safety, disease prevention, and anticipatory guidance. Although group visits may not fit every practice, the format does offer to both obstetricians and pediatricians some exciting possibilities. The increased patient-provider contact and the increased patient participation help establish better rapport, better educate families about health, and hopefully, will produce better babies.