Table 1.

Well-Child Care (WCC) Delivery Challenges.

Participants identified 3 significant challenges in WCC delivery current care at their community clinics:
Theme 1: Delays due to insurance and intake paperwork
“We get delayed—you know, sometimes, because of the insurance … [parents] don’t pick up the [insurance] form or it doesn’t go through. Then there’s a huge delay for us to get the parents in [from the waiting room].”
“It’s the paperwork. It just gets overwhelming. … [Parents] just find this like a hopeless thing.”
“… Sometimes you get these parents that bring two kids at a time—new kids … You get like six, seven papers for each child to fill out—it’s a lot of writing. Yeah, a lot of writing.”
Theme 2: Lack of time for parent education and sick visits due to WCC visit volume
“You know, we have so many people assigned to us, and we try to get them in. And I just hear a lot of the pediatricians feel overwhelmed and burned out doing 10 new physicals a day.”
“And also like they schedule like sometimes five physicals in a row. And that’s really bad because the doctor—I mean she has to be in a rush.”
“Sometimes we get so bombarded with physicals… someone will walk in wanting to be seen because their child has a fever … [and] they have to sit and wait and hope that someone doesn’t show up for their appointment … in order to be seen.”
Theme 3: No system to encourage physicians to use non–face-to-face communication methods with parents
“[The clinic phone line is] staffed by—you know, lay people without any real medical knowledge. And they get difficult calls. You know—‘My kid has a fever for two days. Should I bring them in? Or should I take them to urgent care. Or should I take them to an emergency department?’ And they do their best, but they’re really not qualified or trained to answer those kinds of questions.”
“That has been a huge gap—is going through the phone line. And sometimes—again—[patients are] being brought for appointments, and in fact they just really need to talk to you to get some clarification. And now we’ve made them haul their kid in … for nothing.”