Health System Factors Affecting Communication with Pediatricians: Gendered Work Culture in Primary Care

Abstract

This qualitative study examined the roles that practice setting, education level, and gender may play in social workers' communication satisfaction with pediatricians. Taking an ethnographic approach, the researcher interviewed social workers and pediatricians who worked together to provide mental health services in primary care. The results suggested that gender at the health system level may be an issue and that gendered work culture in primary care was a factor in communication. In particular, reimbursement, an aspect of the gendered work culture, was a substantial communication barrier, and the implications for Medicaid billing are discussed.

KEYWORDS:

• Integrated behavioral health
• primary care
• communication satisfaction
• social work

Notes

This project was supported by grant number R36HS017749-01 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the author and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. In addition, this research was sponsored by a fellowship from the UCLA Graduate Division. The author wishes to thank Todd Franke, Rosina Becerra, Alice Kuo, Duncan Lindsey, Rashmita Mistry, Bonnie Zima, Jorja Leap, Neal Halfon and the UCLA Center for Healthier Children, Families, and Communities, as well as Grace Park and Susan dosReis for comments on earlier drafts of this manuscript.