Content and Method of Health Supervision by Physicians in Child Health Conferences in Baltimore, 1959

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Abstract
Physicians in the same program of child health supervision contributed markedly different amounts of time and different amounts of mental hygiene practices. Individual physicians were consistent enough, as measured by this method of classifying and counting sentences, so that differences between physicians are statistically significant. One physician averaged five questions and comments about behavior and development for each child seen. The use of less than one sentence per child by the majority of physicians in the program indicated an amount of supervision in this are that has almost no meaning to the parent or child. The physician who discussed behavior in 23% of his sentences demonstrated that this subject can be given considerable emphasis even in a very brief health conference. The failure of correlation of ranking of physicians in the categories of behavior and hygiene indicated that physicians that emphasized the behavior and development of the child were less likely to discuss feeding, clothing, and washing as routine daily care. The median score for physicians of 1.2 nondirective questions or probes per child indicated that in the majority of instances there is an opportunity for the parent, but no true encouragement, to choose a subject for discussion or to talk through a problem. Assurance was offered as part of almost all child health conferences. The practice of anticipatory guidance is used only by a small group of physicians. The remainder do not use it in any formal or regular manner. Physicians did not use anticipatory guidance in proportion to the frequency of use of other mental hygiene practices.

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