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Vermont Child Development Clinic,
Burlington, VT.
| OBJECTIVES |
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| Introduction |
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Primary care physicians are under increasing pressure to obtain standardized documentation for the conditions they encounter. The most obvious pressures stem from managed care. Among the most frequently imposed expectations of primary care physicians are to:
Be gatekeepers for most forms of care needed by patients. Offer increasingly diverse services to more patients while limiting the time spent with each patient. Provide extensive documentation for assessments of patients and for treatment and referral.To fulfill these expectations, physicians need cost-effective procedures for obtaining, using, and transmitting information about patients.
Childrens behavioral and emotional problems pose special
challenges for meeting such managed care requirements.
Certain types of behavioral problems, such as those ascribed
to attention deficit hyperactivity disorder (ADHD), are
widely publicized as candidates for medical management.
Concerned parents, therefore, may request that pediatricians
and family practitioners evaluate their children for
ADHD. To assess ADHD and other behavioral and emotional
problems, physicians need information from people who see
children in their everyday contexts. Parents and
parent-surrogates are the primary sources of such information for
most children. Older children can contribute useful
information about their own functioning. Teachers are
especially important sources of information when childrens
functioning in school is relevant, such as
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