Reisinger K S, Bires J A
Pediatrics. 1980 Dec;66(6):889-92.
Physicians, by their collective positions in society and their individual interaction with patients, can be facilitators in helping families adopt more healthful ways of living. This study addresses the issue of the amount of time pediatricians in private practice spend with patients during well-child visits and the proportion of that time they devote to discussing potential health problems. The study population consisted of a random sample of pediatricians in the metropolitan Pittsburgh area. Observation of physician-patient interactions were made during one day in each of 23 pediatricians' offices. During the days of observation there were 305 well-child visits. The time spent with each patient averaged 10.3 minutes. Anticipatory guidance constituted 8.4% of total visit time. Pediatricians in group practice or partnerships and those recently trained spent more time with patients and a greater part of their time in anticipatory guidance. The amount of time during the well-child visit spent in anticipatory guidance varied with the age of the patient. The most time discussing potential future problems was spent with parents of infants less than 5 months of age (1 minute 37 seconds), with only an average of seven seconds being spent with adolescents. Of particular note was the lack of time spent discussing issues of safety, sex, behavior and growth. Because pediatricians spend more than 60% of their in-office time seeing patients for well-child care, they have an excellent opportunity to motivate parents and patients to change to more healthful ways of living. This opportunity will be lost however unless pediatricians reorient their priorities by addressing currently unmet health problems.
医生凭借其在社会中的集体地位以及与患者的个体互动，能够成为帮助家庭采用更健康生活方式的促进者。本研究探讨了私人执业儿科医生在儿童健康检查期间与患者相处的时间量，以及他们用于讨论潜在健康问题的时间比例。研究对象为匹兹堡大都市区儿科医生的随机样本。在23位儿科医生办公室中的每一天，都对医患互动进行了观察。在观察期间，共进行了305次儿童健康检查。与每位患者相处的平均时间为10.3分钟。预防性指导占总就诊时间的8.4%。在团体执业或合伙执业的儿科医生以及最近接受培训的儿科医生，与患者相处的时间更长，且他们将更多时间用于预防性指导。在儿童健康检查期间用于预防性指导的时间量因患者年龄而异。与5个月以下婴儿的父母讨论潜在未来问题的时间最长（1分37秒），而与青少年讨论平均仅花费7秒。特别值得注意的是，用于讨论安全、性、行为和成长问题的时间不足。由于儿科医生超过60%的门诊时间用于儿童健康护理，他们有绝佳的机会激励家长和患者转向更健康的生活方式。然而，除非儿科医生通过解决当前未满足的健康问题来重新调整工作重点，否则这个机会将会丧失。
