Child abuse as a stressor of pediatricians.

A survey of: 1) sources of perceived stress, 2) stress management, and 3) burnout among members of the American Academy of Pediatrics Sections on Child Abuse and Emergency Medicine indicates that child abuse physicians are stressed by the history, physical examination, and court appearances in abuse cases. Rarely did physicians indicate that this stress adversely affected their sexual life or family life. Both groups considered courtroom appearances most stressful. Both groups claimed to recognize their stressors and use a variety of approaches to decrease stress. Formal training in child maltreatment was unusual among Abuse Section members, whereas Emergency Section members tended to receive this training in Fellowships. Emergency Medicine Section members reported increased perceived levels of stress. Despite recognition of stress, there was no indicated desire to leave either specialty before an average of 11 to 15 years. Emergency Medicine Section members indicated that 5% of their patients are abused. It is important that emergency medicine residency programs include child abuse education. Formal training programs for individuals who wish to limit their practice to child abuse are needed. Stressors need to be recognized and appropriately managed. Stress recognition and management techniques that have been shown to be effective should be taught and used, beginning in medical school and continuing throughout medical practice. This is necessary if the highest quality of professional personal and patient care is to be maintained.