(EXCERPTS TAKEN FROM THE WINTER 2003
EDITION OF THE NETWORK NEWS)
From the Director
By Mort Wasserman, MD, MPH
2004: A Size Odyssey
PROS grows in response to circumstances. Starting
from scratch in 1986, the network grew through AAP individual chapter
leadership and the personal recruitment efforts of PROS Chapter
Coordinators to 600 member practitioners and 155 practices by the
autumn of 1993. Since then, PROS has tripled in size and now has
over 1800 practitioners in more than 600 practices.
Expanding the network first became a priority in 1993, when PROS
found itself with insufficient members to answer the questions posed
in two large scale projects: the Febrile Infant Study and the Child
Behavior Study. To address this need, PROS used the monthly AAP
News to place a series of articles about PROS research, accompanied
by clip-and-mail "Join PROS!" advertisements. PROS placed
a similar clip-and-mail ad in the journal Pediatrics. The response
to this marketing recruitment strategy was remarkable and PROS more
than doubled in size over three years. In the years since, PROS
has grown at a more measured rate - around 5% per year. However,
in 2003, PROS once again needs to become bigger.
Why does PROS need to grow? Quite simply, the network has more opportunities
to advance its mission than current size will allow. From a fiscal
standpoint, PROS needs to be doing several studies at once in order
to survive. But PROS practitioners are certainly not expected to
take part in every study. The network therefore needs a membership
of sufficient size so that multiple studies can take place at the
same time, and so the minority who participate in any individual
study comprise a large enough sample to answer the questions posed
by that study. This year, PROS is in the midst of conducting two
large-scale projects (defined as needing 100+ practices): Safety
Check and Child Abuse Reporting Experience Study (CARES). A third
large-scale study, Translating Immunization Research Into Practice,
is on the launching pad.
In addition, the network's partiality towards the intervention studies
most consistent with its mission requires more preliminary pilot
work per project than was typically needed to develop descriptive
studies. Pilot projects - current examples are the Learning from
Errors in Ambulatory Pediatrics and Healthy Lifestyles Study - require
additional participation from the network.
How will PROS grow? Clearly, tried-and-true marketing approaches
are the most
cost-effective. This past April, the AAP News had a cover article
on current PROS studies, accompanied by the traditional clip-and-mail
coupon. We're also trying some new marketing tactics. In May, the
AAP News featured a colorful advertising insert (of the kind usually
used by the pharmaceutical industry). In June, an AAP "blast"
e-mail sent to all electronically-connected members headlined the
message, "REKINDLE THE INTELLECTUAL EXCITEMENT OF PRACTICE!"
and describing why practitioners should join PROS. Each has resulted
in many inquiries about joining the network, and this mass marketing
approach will continue. I personally believe, however, that word
of mouth from PROS practitioners is the network's most powerful
marketing tool. It is likely that most of the practitioners who
respond to our anonymous marketing approaches act in the context
of knowledge obtained from colleagues about the network. PROS practitioners
create the climate in which PROS recruitment efforts work.
I encourage each PROS member who has found her or his participation
in the network rewarding to talk the network up. Please promote
PROS. Should each active member convince a single colleague to join,
PROS would complete the latest stage of its "Size Odyssey."
Our goal is 2004 (members) by 2004!
Please send any additional ideas that you may have for spreading
the word about PROS to me at rwasserman@aap.org.
From The Steering Committee Chair
By Paul Z. Bodnar, MD
Opening New Doors
Who are we? We are a busy and largely successful primary care research
network. Or are we?…. and what must we do differently/better?
The PROS Steering Committee, PROS staff, and a number of invited
guests convened in September for PROS third "retreat":
an opportunity to reflect on where PROS has been, and where we should
be going.
Early results from the Value of PROS study helped us understand
how well we are meeting your needs and fulfilling the interests
of our practitioners and practices. But, the PROS mission is: "To
improve the health of children and enhance primary care practice
by conducting national collaborative practice-based research."
Is this the "right mission?" What do we really accomplish?
We who comprise the network, want to know that our efforts make
a difference. Our funders (Maternal and Child Health Bureau, Agency
for Healthcare Research and Quality, other federal agencies, private
foundations, and the AAP) feel the same way about their financial
support. Are our study results producing practice changes? Are we
highlighting what pediatric practitioners do that is of significant
value, and are we increasing that value? Are we studying the most
meaningful topics? Are we pointing the way to cost-effective health
care interventions? How much should we pursue quality improvement
initiatives in our offices? How should we monitor our effectiveness
in years to come?
And what is this PROS network that we have all created? How representative
are we, and of what? Some of us do multiple studies over the years,
some of us none, or one, or two. How well does our communication
tools work for us? Does the current structure of central PROS staff,
Chapter Coordinators and biannual coordinator meetings effectively
serve our needs? How well are we mining the interests and energy
of our practitioners and our network?
We've become a much more complicated group over the years: larger,
more diverse, performing much more difficult studies. Of necessity,
there are long lag times in evolving, funding, then executing studies
in our network. What are the implications of these changes to the
network? How can we preserve the unique excitement of making our
individual contributions to the science of pediatric care, and the
welfare of our patients and families?
Please let me know your thoughts on any or all of the above issues.
Let me know what additional questions and directions the network
should pursue. Help create the PROS Network that you want to see
over the next five to ten years.
E-mail responses to: pzbodnarmd@aol.com
or send to:
Paul Z. Bodnar, MD
Main Street Pediatrics
515 Fairmount Ave, Ste 200
Towson, MD 21286
