AAP responds
Susan Kressly, MD, who chairs AAP’s Section on Administration and Practice and is a consultant based in Sanibel, Fla., said that we know that using targeting screenings will miss a significant proportion of patients whom you could better assist and care for; for example, if you just go by your gut feeling about whether kids are using drugs or alcohol and just screen those kids. Every screening endorsed by AAP has some degree of evidence for use at a population level rather than case by case, Dr. Kressly noted.
This doesn’t mean that every single screening must be done at each and every recommended interval, she emphasized.
“The first priority is what’s important to the patient and the family. While we understand that screening is at a population health level, there should be some intelligent use and prioritization of these screening tools,” Dr. Kressly said. As examples, Dr. Kressly noted that there is no need to keep administering autism screenings in families whose children already receive autism services, or to ask a teenager questions about anxiety they had answered 6 weeks earlier.
The screenings should be seen as a tool for enhancing relationships with children and their families, not as a series of endless tasks, Dr. Kressly concluded.
Dr. Lessin’s priority is that pediatricians get more support – time, money, training, adequately resourced mental health care – to carry out their expanded role.
“Pediatricians are pretty nice. We want to do the right thing, but everything blocks us from doing it,” Dr. Lessin said.
Dr. Joos, Dr. Kinsella, and Dr. Lessin are on the MDedge Pediatric News Editorial Advisory Board.