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MNAAP Newsletter

Screening Instruments: Autism Spectrum Disorders

By Michael Reiff, MD, FAAP

michaelreiffWith the current prevalence of autism spectrum disorder (ASD) estimated at 1 in 68 children and rising, it is imperative that pediatricians take an active and informed role in identifying children at risk. Despite a great deal of effort regarding early identification, parents generally report initial concerns before their child is 18 months and still the average age of diagnosis remains at about 4-5 years of age. It is important that screening tools used by pediatricians be as evidence based as possible to avoid over- or under-referral for diagnosis.

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Screening Instruments: Developmental Screening

By Elsa Keeler, MD, FAAP and Katy Schalla-Lesiak, MSN, MPH, APRN, CPNP

ElsaKeelerKaty Schalla LesiakUniversal developmental screening works and closes the gap. Since the AAP recommended standardized developmental screening in 2006, research continues to show that screening significantly improves our ability to identify developmental delays earlier and more accurately. Currently in Minnesota, less than 3 percent of children under age 3 are receiving Early Intervention (EI) services, despite a national estimate of 13 percent of children in this age group eligible for services.

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Word from the President

By Sue Berry, MD, FAAP, president

SueBerryIt’s fall and the beginning of our Chapter’s action year. Two meetings that are important for our chapter activities have recently taken place.

The first was our Chapter board meeting. Though our fiscal year runs from July 1 to June 30, the first meeting of the year for our board happens in the fall. I was very impressed with the breadth and depth of our board – they will represent you and the children of Minnesota well.

The second was one many of you might not know as much about. Over the last two years, MNAAP has participated in a coalition of primary care provider organizations. This includes our colleagues in internal medicine, family medicine, osteopathic medicine, and physician assistant and advanced practice nursing organizations. The fall meeting of the group continued our work defining areas for common effort to support families and children particularly in legislation. Topics ranged from the use of patient outcomes as a measure of quality to provider resilience. Again, I was impressed by the commitment of all of these organizations to focus on patient needs.

I hope as the year progresses that we will all continue to work together for Minnesota kids. Our past board member, Dr. Sarah Jane Schwarzenberg, has done this in a big way. She just completed work as lead author on the AAP statement “Promoting Food Security for All Children.” I recommend that you all read it and learn more about what we can do as a professional group to meet this important goal. Please offer her your thanks when you see her!

 

Suspicions of Child Abuse or Neglect Must Be Reported

By Lisa Guetzko, MD, HealthPartners Central Minnesota Clinic

LisaGuetzkoDiagnosing and reporting suspected child abuse or neglect is one of the greatest challenges a pediatrician must face. Besides the obvious primary concern for the child’s welfare, there are numerous other considerations that can affect our decisions about whether or not to file a child protection report. Time constraints, diagnostic uncertainty, logistical barriers, lack of knowledge about proper reporting protocol, and fear of alienating the patient’s family or losing them to follow up may all play a role in the clinician’s decision. Although we are all aware that we are mandated reporters, it is often unclear exactly when, why, and how to report a suspicion of child abuse.

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Beating Burnout: Tips from a Rural Clinical Team

By Corey Martin, MD, and Christy Secor, RN, MSN, Buffalo Hospital

Corey Martin

Physician burnout is a topic increasingly recognized as a problem facing health care, having implications on quality of patient care and quality of life for ourselves and our colleagues. How we approach this as organized medicine, health systems,and individuals is extremely important.

Multiple studies have shown that nearly 50 percent of American physicians experience feelings of emotional exhaustion, cynicism, and decreased job satisfaction. Studies indicate physicians experiencing burnout have decreased levels of professionalism, poorer quality outcomes, and an increased risk for medical errors. Burnout also contributes to strained relationships at work and at home, increased rates of alcohol use, thoughts of suicide, and is leading physicians to leave the workforce at younger ages.

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