In this issue of JAMA Pediatrics, Ray et al1 reported a decrease in primary care visits from 2008 to 2016 in a commercially insured child and adolescent population. This decrease occurred in acute care visits, whereas preventive care visits increased substantially during the same time frame. The findings document change in the content of primary care, from acute problem-oriented care to more preventive services and potentially some increased attention to mental health, insofar as the only condition group to have an increase over the study period was psychiatry or behavioral. These changes appear in the context of much other change in the organization and financing of pediatric care, as well as changing family structure and workforce participation and expanding internet availability. Do these findings presage new critical issues for pediatric practices or do they mainly document what is known and already changing?
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Perrin JM, Oreskovic NM. Changing Pediatric Primary Care. JAMA Pediatr. Published online January 21, 2020. doi:10.1001/jamapediatrics.2019.5532
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