Child protection referral issues for general practitioners/family physicians
Bibliographic record
Abstract
The purpose of this research was to investigate why GPs/FPs are having difficulty collaborating with other health and human service professionals on matters of child protection. Since the symptoms of a child in need of protection are often hidden and can easily be minimized or attributed to something else, an assertiveness to rigorously investigate ambiguous symptoms is required. This research applied Organizational Citizenship Behaviour theory to understand some of the barriers and facilitators to assertive collaboration. The research survey of 190 GPs/FPs in Vancouver B C , showed that the referral process in child protection cases is lengthy (often a few hours over several weeks), and the GP/FP is rarely remunerated for this time. Most GPs/FPs believe that it takes longer to refer to non-MDs than to MDs. GPs/FPs who refer to non-MDs have more interprofessional education (mentoring, CCFP certification), and work in group practices more often than in solo practices. GPs/FPs who are paid by fee-for-service refer to non- MDs less often than those who are paid by other methods (e.g., salary). Abundant additional information was collected beyond the basic research question, mainly for future research. Some of these data are striking: many GPs/FPs have never referred a child/family for a child protection concern; most child protection referrals are to pediatricians and then to psychiatrists; the GPs/FPs who stated that non-MD referrals take longer than M D referrals referred more to pediatricians and psychiatrists than to non- MDs; the GPs/FPs who refer to non-MDs stated that it took the same amount of time to refer to non-MDs or MDs. Another distinctive finding was that the survey comments showed strong GP/FP frustration with the lack of help for children and their families, including some alarming examples. The work reported here provides data about MD/non-MD collaboration, discusses practice implications, and offers suggestions about how to encourage child protection referrals from GPs/FPs particularly to non-MD health and human service professionals. GPs/FPs may be the province's most accessible, powerful professional resource for children and their families, and the least motivated to take action.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.014 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".