How well do you know your child's pediatrician?

Jun 1 2007

Is he or she board certified in pediatrics, or has he or she ever completed specialty training in the field?

Findings from a new study from the University of Michigan C.S. Mott Children's Hospital's Child Health Evaluation and Research (CHEAR) Unit may prompt parents to find out if their child's physician really is who he claims to be – a board-certified and specialty-trained pediatrician.

The study, published in the June issue of the Journal of Pediatrics, found that as many as 17 percent of physicians in a single state who claim to be pediatricians on state licensure files have never been board certified as a pediatrician by the American Board of Pediatrics (ABP). And another 12 percent of physicians who report to be pediatricians did not complete a medical residency training program in pediatrics.

“Residency training in pediatrics and board certification by the American Board of Pediatrics distinguish the physician as having the level of expertise and knowledge to provide the best possible care for your child,” says study lead author Gary L. Freed, M.D., MPH, chief of the Division of General Pediatrics and director of the CHEAR Unit at Mott.

He continues, “Our finding that up to 17 percent of those reporting to be pediatricians in a given state are not board certified by the ABP should encourage more parents to find out if their child's physician really has been board certified as a pediatrician, and that he or she has maintained that certification status. Recertification is equally important because medicine is constantly changing, and it is a means to keep physicians up-to-date on the latest medical developments.”

So why are some physicians able to claim to be pediatricians without the proper training and certification? Freed says many state licensing boards allow physicians to self-declare their areas of expertise without verifying the information.

To study the accuracy of such self-reporting systems, the CHEAR Unit team gathered state licensure data for all active physicians in two randomly selected states in each region of the United States – Ohio and Wisconsin, Texas and Mississippi, Massachusetts and Maryland, and Oregon and Arizona. The state data were then matched with the ABP's listing of all pediatricians who have ever received board certification, regardless of their medical training history.

The proportion of “unmatched” physicians ranged from 6.9 percent in Massachusetts to 16.8 percent in Maryland, with the researchers finding, on average, 11 percent of physicians who claim to be pediatricians on the state licensure files were not listed by ABP as having as ever been board certified in pediatrics.

The researchers then sent a survey to nearly 400 active physicians in all eight states who appear as pediatricians on state licensure files, but had no certification record with the ABP. Of the 255 physicians who responded to the survey, 61 percent say they had completed residency training in pediatrics. Nearly half reported they had some current board certification, and of these, 53 percent say they were certified by a board other than the ABP. Freed also notes that 12 percent of physicians who report to be pediatricians did not complete a pediatric residency training program.

“This is a reminder to parents that just because physicians claim to be pediatricians, it doesn't necessarily mean that they are board certified by the ABP or have ever been certified, or even received the appropriate training to be designated as a specialist in the field of pediatric medicine,” warns Freed, the Percy and Mary Murphy Professor of Pediatrics and Child Health Delivery at the U-M Medical School and professor of health management and policy at the U-M School of Public Health.

“Parents have the right to have high expectations for the physicians they have entrusted with their child's care. They should feel empowered to ask physicians if they are board certified in their field of expertise,” he says. Parents also can go online to check a pediatrician's board certification status via the ABP: www.abp.org.

Finding a pediatrician that's right for you and your child:

While parents often opt to have a pediatrician to provide care to their child, many will instead choose a family medicine practitioner to handle their child's – and even the entire family's – medical needs. Freed says physicians who specialize in family medicine are trained and very capable of caring for children. If a family, however, decides to have a pediatrician care for their child, Freed offers the follow six tips to help guide parents in selecting a pediatrician:

1. Board certification and specialty training. Board certification demonstrates that the physician has the knowledge, skill and experience to offer the highest quality of care in the field, and pediatricians are required to undergo recertification through the American Board of Pediatrics every seven years. To check on a pediatrician's board certification status, visit the ABP at http://www.abp.org
2. Office hours. Does the pediatrician hold office hours that will work with your family's busy schedule? Is the pediatrician available to handle patient care needs after regular business hours? The pediatrician's schedule needs to be a good fit for your family's schedule in order for the relationship to be a success, Freed says.
3. Ability to care for children with chronic diseases. Is the pediatrician experienced in caring for children with chronic diseases such as asthma or diabetes? The American Lung Association estimates that 6.2 million children under age 18 currently have asthma, so having a pediatrician who is able to provide your child with the necessary care for such chronic diseases can be important.
4. Association with major medical center. Pediatricians who are associated with a major medical center, such as U-M C.S. Mott Children's Hospital, are able to easily refer patients for specialty medical care services – rheumatology, cardiology, oncology and neurology – when needed.
5. Health care philosophy. Does the pediatrician share your views on health care for your child? It's important that parents find a pediatrician who agrees with their views on what keeps a child healthy, disease prevention, and treatment options.
6. Gender. As children grow from infants to an adolescents, they may feel less comfortable discussing their changing bodies with a physician of the opposite sex. While adolescence may be years away, Freed encourages parents to plan ahead, and select a pediatrician with whom their children will feel most comfortable as they grow.

In addition to Freed, co-authors from the CHEAR Unit in the Division of General Pediatrics are Rebecca L. Uren, MHSA, Ericka J. Hudson, MHSA, and Indu Lakhani, MBA, MS; and the Research Advisory Committee of the American Board of Pediatrics.

The study was funded by the American board of Pediatrics Foundation.
Reference: Journal of Pediatrics , Vol. 150, Issue 6.