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Physician Perspectives on Providing Primary Medical Care to Adults with Autism Spectrum Disorders (ASD).

TitlePhysician Perspectives on Providing Primary Medical Care to Adults with Autism Spectrum Disorders (ASD).
Publication TypeJournal Article
Year of Publication2015
AuthorsWarfield, MErickson, Crossman, MK, Delahaye, J, Der Weerd, E, Kuhlthau, KA
JournalJournal of Autism and Developmental Disorders
Volume45
Issue7
Pagination2209-17
Date Published2015 Jul
ISSN1573-3432
Abstract

We conducted in-depth case studies of 10 health care professionals who actively provide primary medical care to adults with autism spectrum disorders. The study sought to understand their experiences in providing this care, the training they had received, the training they lack and their suggestions for encouraging more physicians to provide this care. Qualitative data were gathered by phone using a structured interview guide and analyzed using the framework approach. Challenges to providing care were identified at the systems, practice and provider, and education and training levels. Solutions and interventions targeting needed changes at each level were also proposed. The findings have implications for health care reform, medical school and residency training programs, and the development of best practices.

DOI10.1007/s10803-015-2386-9
Summary

Lead Author Marji Erickson Warfield, Morgan K. Crossman

Study Aims and Objectives To better understand how providers who care for adults with Autism Spectrum Disorder (ASD) became interested in serving this population, their training, the challenges they face, and their ideas for growing the number of physicians who offer this care.

Methods - Sample, Procedure, Study Measures, Analysis
Using a structured interview guide, members of the research team interviewed 10 health care professionals who provide primary care to adults with ASD. Each participant was provided the guide prior to the phone interview. A three-stage approached was used to analyze the findings. First, a member of the team read through the transcript several times to uncover common themes. Next, a second member independently reviewed the transcripts to find overlap in the themes. Last, the data was further examined to find possible associations within and among the thematic groups.

Results – Main Finding(s)
Providers described several challenges including a shortage of services and support for adults with ASD, a general lack of providers willing to work with this population, and financial disincentives for providers (more time is often spent assessing those with ASD, so providers have less time to see other patients). Furthermore, providers noted that a lack of formal training made them feel less confident in caring for those with ASD. Participants also addressed possible ways of reducing these problems such as creating policies to ensure reimbursements, limiting wait times for patients with ASD, and providing official ASD-related trainings in medical school or residencies.

Conclusion – Summary Statement
Changes are needed to better support provider’s efforts to address the needs of adults with ASD. Bringing together ASD-specific physical and mental health resources with primary care, a model known as a medical home, may address some of these concerns. Additionally, changes in policy due to healthcare reform may reduce problems with provider reimbursement. It is further recommended that medical students and residents receive training in treating patients of all ages with ASD and other disabilities.

Alternate JournalJ Autism Dev Disord
PubMed ID25724445
Grant ListR40 MC 19925 / / PHS HHS / United States