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Is Child Psychiatric Service Different When Provided by Attendings Versus Clinicians-in-Training?

Received September 27, 2006; revised February 7 and August 14, 2007; accepted October 16, 2007. Dr. Williams is affiliated with Child and Adolescent Psychiatry at Stanford University in Palo Alto, Calif.; Dr. Martin is affiliated with the Judge Baker Children’s Center in Boston; Dr. Dyer-Friedman is in private practice; Dr. Huffman is affiliated with General Pediatrics at Stanford University and with The Children’s Health Council. Address correspondence to Sharon E. Williams, Ph.D., Child and Adolescent Psychiatry, Stanford University, 401 Quarry Rd., Stanford, CA 94305-5719; sharonw{at}stanford.edu (e-mail).

OBJECTIVE: This study examines the clinical management characteristics of outpatient child and adolescent psychiatric care provided by attendings and clinicians-in-training in an academic institution. The authors hypothesized that no significant differences would exist between initial evaluations conducted by attendings and those conducted by clinicians-in-training. METHODS: The amount of information obtained during an initial evaluation and the number and type of services recommended postevaluation were assessed for 429 patients treated in the child and adolescent psychiatry clinics at Stanford University by attending psychiatrists and clinicians-in-training. RESULTS: No significant differences were found for the evaluations conducted by attendings and clinicians-in-training for the amount of data collected during an evaluation of the number or type of recommendations made postevaluation. CONCLUSION: These findings lend themselves to the conclusion that attendings and clinicians-in-training offer comparable services in the assessment of new patients. Study limitations and future areas of study are discussed.

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