Interprofessional training in developmental and behavioral health within a pediatric residency program: An organizational systems case study

Abstract

A systemic issue in traditional health service delivery models to children and adolescents is the difficulty in accessing quality developmental/behavioral health (D/BH) care. Contributors to this problem include the lack of available specialty D/BH specialists (e.g., child and adolescent psychiatrists and psychologists, developmental-behavioral pediatricians), as well as issues with insurance coverage and reimbursement when these services are paneled through behavioral health “carveouts.” Given the difficulty in accessing these services, primary care physicians such as pediatricians and pediatric residents often become the de facto D/BH providers. However, a major barrier that these providers express in managing D/BH concerns is the lack of training they receive in medical school and residency. This chapter presents an organizational systems-level case study detailing how concerned stakeholders in a healthcare delivery system and training program have responded to problems pertaining to the need for improved care and resident training in D/BH. The case study intends to inform those who design, revise, and operate service delivery and training systems on a daily basis. To facilitate amore nuanced examination of implementation experiences, a simulated question and answer discussion is included at the end of this chapter.