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Survey: Pediatricians value medical home but face challenges :

November 3, 2016

New research using data from an AAP Periodic Survey of Fellows shows that pediatricians clearly support the value of family-centered medical home (FCMH) principles, but they also experience barriers to implementation (Tschudy MM, et al. Pediatrics. 2016;138:e20153458,

In the survey, pediatricians were asked about their attitudes concerning FCMH principles (see table). Three of four pediatricians reported agreement or strong agreement that having a FCMH encourages patient use of preventive care and decreases unnecessary or preventable use of the emergency department or hospitalizations. Eighty percent of pediatricians further agreed or strongly agreed that having a FCMH improves children’s health care.

Pediatrician attitudes concerning family-centered medical homes

Having a family-centered medical home…

Disagree or strongly disagree


Agree or strongly agree

Improves children’s health care.




Encourages patient use of preventive care.




Decreases unnecessary or preventable use of the emergency department or hospitalizations.




Source: Tschudy MM, et al. Pediatrics. 2016;138:e20153458.

Twelve percent of pediatricians worked in practices that had applied for formal patient-centered medical home recognition or accreditation. Sixty-one percent reported that their practice had not applied, while 27% did not know whether their practice had applied. No association was found, however, between pediatricians’ medical home attitudes and whether their practice was formally recognized or accredited.

Pediatricians reported experiencing barriers to FCMH implementation. The most commonly reported barrier was a lack of sufficient/appropriate personnel to facilitate the components of the FCMH (58%). This was followed by a lack of time to make the practice changes necessary to adopt a FCMH (43%). Roughly one in 10 pediatricians reported not having the communication skills needed to lead coordinated care activities.

Periodic Survey #79 was conducted from September 2011 to February 2012. Surveys were mailed to 1,622 non-retired AAP members in the U.S., with a response rate of 59%. Responses were based on 572 respondents who provide primary care in an ambulatory office-based or clinic-based setting.

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