The Swiss paediatrician and the social problems of families

Objective The objective of this section of the study ‘Schoolchildren in the Pediatric Practice’ was to describe the current experiences of the practising paediatrician in dealing with the social problems of their patients and families.

DESIGN For the base study, paediatricians in private practice used a standardized form to register schoolchildren who came to the practice on selected days during the two year-long research segments. Personal, demographic, social and medical information was recorded. During the semi-structured interview at the end of the study, each paediatrician contributed highly personal examples, insights, and opinions about the psycho-social dimension of childcare.

SETTING AND SAMPLE Thirty-four paediatricians practising in the canton of Bern, Switzerland collected a sample of 5971 schoolchildren, aged 6–16 years.

Results The paediatricians recorded a definite or suspected case of social problems in the schoolchild's family in 20% of the sample. Quotations from the physicians are used to illustrate what kind of problems they see, how they access information, how willing they are to assist with a problem, and how well formal training prepared them for the task. A total of 83% of the paediatricians denounced the inadequacies of their formal preparation in this area.

Implications To better prepare the paediatrician for a job with an increasing psycho-social dimension, it is recommended to develop a model curriculum in psycho-social paediatrics, to increase the use of the option for a practicum in a private practice during formal training, to press for coverage by health insurance for a wider scope of activities, and to address the issues implicated in networking with other child-assistance professionals.