Many children with special needs receive services
from several providers, including general pediatricians,
subspeciality pediatricians, speech and
physical therapists, nutritionists, psychologists, social
workers, and case managers. As a whole, this
population is quite varied in the number and type
of providers utilized, and the relative importance of
these providers in managing the child’s condition.
For example, some children with chronic illnesses
or disabilities may have a primary care physician
and a subspecialist, each with distinct roles; other
children in this population may have a primary
care pediatrician who handles most or all of the
specialized care; still others may have a subspecialty
pediatrician who meets all or most of their
primary care needs. Each provider has a different
but potentially overlapping set of roles and responsibilities.
10,11 Specific arrangements vary from family
to family, and may vary within a particular
family over time as the child moves through new
developmental stages or as the condition changes
in its expression. A survey that refers to only 1
provider (such as the primary care provider [PCP])
will fail to capture satisfaction with other members
of the health care team who may be equally or more
important to the child’s health status and medical
outcomes.