The impact on families of pediatric resident departure from a continuity clinic practice

Objective: To determine views of parents whose children were reassigned to new resident pediatricians at a continuity clinic because their previous pediatricians had completed residency. Design: Cross-sectional survey. Setting: Hospital-based resident continuity clinic. Participants: Ninety parents whose pediatricians were graduating were interviewed from June through August 1995. Results: Most parents felt they knew their resident pediatrician well and that the resident knew their child well. Sixty-eight parents (76%) were sad about the transition, 33 (37%) were angry, 30 (33%) felt abandoned, and 6 (7%) were relieved. Three fourths of the parents thought it was very important for the family to be involved in the reassignment process, yet less than one fifth had been asked their opinion. Half of the families were experiencing their second or greater transition. Families undergoing their first, vs second or greater transitions, were more likely to feel they knew the resident well (P=.01), and that the resident knew their child well (P=.04). Despite the transitions, 86 (96%) of families stated they would continue to have their child receive medical care at the current site because they knew their child would receive good care. Conclusions: Strong physician-patient-parent relationships develop when residents are the pediatric primary care providers. Parents want to be informed regarding transitions. Pediatricians need to be sensitive to the impact of transitions and to negotiate with families in choosing their future pediatrician. These results have implications for other practice sites where physician turnover occurs.