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Clinical Inactivity Among Pediatricians: Prevalence and Perspectives

Freed GL, Dunham KM, Switalski KE; Research Advisory Committee of the American Board of Pediatrics
Pub Med #: 

During their careers, physicians may have periods of clinical inactivity for a variety of reasons. Concerns have been raised about the impact of clinical inactivity on the growing physician workforce shortage. It is unknown how these periods of clinical inactivity impact physician competence and patient safety. With this study we sought to determine the rates of clinical inactivity, the duration of periods of inactivity, professional activities during those periods, and the perspective of pediatricians regarding future requirements of competency for return to clinical practice.

Patients and Methods
A random sample of 6757 American Board of Pediatrics diplomates aged < or =65 years received a structured questionnaire by mail. The survey explored the prevalence of and reasons for clinical inactivity and perspectives on the return to clinical practice. Clinical inactivity was defined as a period of absence of > or =12 months from any direct or consultative clinical care.

The response rate was 74%. Of respondents, 88% (n = 4176) were currently engaged in pediatric clinical care. Twelve percent (n = 554) indicated that they had experienced a period of clinical inactivity lasting > or =12 months. Women were more likely than men (16% vs 7%) to have had periods of clinical inactivity. Controlling for gender, generalists were no more likely than subspecialists to report a past period of clinical inactivity. More than one third of the respondents (n = 1672 [36%]) agreed that pediatricians who return from clinical inactivity after >1 year should undergo a competency evaluation.

Almost 1 in 8 pediatricians has suspended clinical care for > or =1 year, and a similar proportion of respondents were inactive at the time of our survey. Currently, all of these physicians may maintain both their licensure and board certification during these periods. The impact of clinical inactivity on patient care and patient safety is unknown.