title: Factors associated with practice of procedures in pediatric-related areas among certified pediatricians.
abstract: BACKGROUND
  Medical care in pediatric-related areas in which physicians other than pediatricians, such as surgeons, otolaryngologists, ophthalmologists, orthopedists and dermatologists, can also participate is one of the fields of pediatric primary care. Independent factors associated with the practice of specific procedures in pediatric-related areas by certified pediatricians in Japan were evaluated.
  
  
  METHODS
  Data were collected from a nationwide survey of 1116 pediatricians who were selected by systematic sampling from the list of certificated members of the Japan Pediatric Society. The survey included questions relating to full- or part-time practice, types of practice setting, practice with or without pediatric subspecialty interest, numbers of procedures performed among 15 procedures in pediatric-related areas, and attitude toward practice of those procedures.
  
  
  RESULTS
  Of 79% of respondents, 73% were analyzed (n=810). Among 15 procedures in pediatric-related areas, seven procedures performed by more than 30% of certificated pediatricians were evaluated. In comparison with certified pediatricians who annually performed three or less procedures (n=410), certified pediatricians who annually performed four or more procedures (n=400) were more likely to be young and male, working full-time and in a general hospital setting, practicing with a pediatric subspecialty interest. In multiple logistic regression analyses, young age (odds ratio [OR]: 0.8 per 10 years of age; 95% CI: 0.6-0.9), positive attitude toward practice (OR: 1.7; 95% CI: 1.6-1.9), male (OR: 1.7; 95% CI: 1.1-2.5), full-time practice (OR: 3.2; 95% CI: 1.5-6.9), and practice in general hospital setting (OR: 1.7; 95% CI: 1.2-2.4) were independently associated with more extensive practice of procedures in pediatric-related areas.
  
  
  CONCLUSIONS
  A positive attitude toward medical care in pediatric-related areas is one of the most important factors associated with practice of procedures in these areas. An educational strategy for pediatricians to keep their motivation high for improved medical care in these areas should be planned in Japan.
authors.affiliation: Department of Community and Family Medicine, Jichi Medical School, Tochigi, Japan. u-ritei@jichi.ac.jp
authors.forename: Ritei
authors.initials: R
authors.lastname: Uehara
authors.forename: Masanobu
authors.initials: M
authors.lastname: Okayama
authors.forename: Eiji
authors.initials: E
authors.lastname: Kajii
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Eto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010372:Pediatrics / Q000706:statistics & numerical data*; D010822:Physicians, Women / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D011364:Professional Practice