TOPLINE:

Nurse practitioners (NPs), physician assistants (PAs), and physicians in pediatric urgent care frequently experienced pressure to satisfy parental expectations or requests that added stress to their roles and often led to altered workup and management plans, according to a survey-based study.

METHODOLOGY:

• Researchers distributed an electronic survey via the Research Electronic Data Capture application to 644 providers (NPs, PAs, and physicians) employed at a pediatric urgent care setting in the US, with reminders sent at 2, 4, and 6 weeks after initial distribution.
• Providers reported how frequently (never, rarely, sometimes, often, or very often) they felt pressured over the past 6 months to satisfy parental requests for antibiotics or steroid s, laboratory testing, imaging, and other interventions when not medically indicated.
• Follow-up questions assessed how frequently (never, sometimes, or always) parental pressure altered providers’ ultimate management plans.
• Providers rated their agreement on whether parental requests added stress to their roles, strained parent/patient interactions, diminished their decision-making autonomy, and affected their ability to provide quality, evidence-based medical care as well as whether parents were amenable to education or counseling when management plans differed from expectations.

TAKEAWAY:

• A total of 150 providers completed the survey, with a response rate of 23%.
• Providers most frequently reported pressure to alter their management plans for prescribing topical antibiotics (P = .047) and ordering chest x-rays (P = .047), strep testing (P = .006), and viral testing (P ≤ .001).
• Overall, 77% of the respondents “agreed” or “strongly agreed” that parental pressure added stress to their roles, and these providers reported greater strain on parent/patient interactions (P ≤ .001) and diminished decision-making autonomy (P = .003) compared with those reporting less stress.
• A total of 66% “agreed” or “strongly agreed” that parents were amenable to education or counseling when management plans differed from expectations, and 90% agreed or strongly agreed that they could provide quality, evidence-based medical care under pressure.

IN PRACTICE:

“Providers can utilize education/counseling of parents/patients to address those pressures to ensure they provide quality, evidence-based medical care,” the authors wrote.

SOURCE:

This study was led by Daniel Moscato, MS, PM Pediatric Care, New York Institute of Technology, New York City. It was published online on February 1, 2026, in The Journal of Urgent Care Medicine.

LIMITATIONS:

This study surveyed providers from a single urgent care organization, which limited generalizability to other populations or settings. Recall bias represented a potential limitation. Geographic variations in parental requests or expectations may have influenced response frequencies due to region-specific illness outbreaks during the study period. Social desirability bias may have affected how providers reported their willingness to alter management plans based on parental expectations. 

DISCLOSURES:

No funding was reported for the study. The authors did not report having any conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.