DEVELOPMENTAL-BEHAVIORAL PROBLEMS IN GENERAL PEDIATRICS

Objective: To determine the current role of private general paediatric s in the care of children with problems of development and behaviour. Methods: We surveyed all general paediatricians registered with the Au stralian College of Paediatrics to assess their current role in develo pmental-behavioural (DB) problems-their rate of referrals, their role in the continuing management, and opinions regarding duration of train ing in this area. Results: Of 394 questionnaires sent, 284 replies wer e received (72%). From these 284 we analysed results for all 172 who s pent more than 25% of their time in private general paediatric practic e. On average, 32% of new referrals were for DB problems. With 10 DB c linical vignettes presented, paediatricians chose to continue to manag e in conjunction with allied health services in 65% of cases. Other ma nagement choices included referral to a multidisciplinary team (16%), referral elsewhere (10%) and manage alone (7%). For training to be a g eneral paediatrician, they indicated 3 months should be spent during b asic training in each of the three areas of; DB paediatrics, developme ntal disabilities and child psychiatry (separately or concurrently); a nd 6 months of each during advanced training. Free comments highlighte d lack of public allied health and psychosocial services. Conclusion: Private community-based general paediatricians are deeply involved in this area of work. The results raise questions about services for trai ning and for clinical collaboration between public and private child h ealth providers.