PAEDIATRICIANS: ARE THEY JUST LITTLE ADULTS?
Authors: Tabner A , Johnson G , Jones M , Patel R , Husk K , Parish R , Rees J , Henstridge V , Clark I , Thomas V , Hearnshaw C 
Published: November 2016

Objectives & Background

Being well acquainted with the oft-repeated premise that “children are not little adults”, we set out to test the hypothesis thatpaediatriciansare little adults.

Methods

DesignInternational cross-sectional study.

SettingSix hospitals (both academic and non-academic centres) in the United Kingdom and New Zealand.

ParticipantsSample of 61 paediatricians, 57 emergency medicine physicians, 31 general internal medicine physicians and 15 healthcare of the older person physicians were recruited; there were no losses to follow-up. All potentially eligible participants (doctors with >2 years experience in one of the above specialties) at the study sites were invited to take part; all willing participants were recruited. Specialties excluded were surgery, anaesthetics, intensive care (and the paediatric versions thereof) as well as specialties such as microbiology and pathology that have little patient-facing contact.

Main outcome measuresHeight (cm), weight (kg), BMI, head circumference (cm), shoe size (UK system), gender, speciality, age, years in speciality, whole time equivalence, institution, country of birth, country of practise.

Results

Paediatricians were significantly shorter than non-paediatricians (mean height 168.0 v 173.9 cm; mean difference 5.9 cm; 95% confidence interval 2.8 to 9.1; p<0.001). This difference was maintained when adjusted for participant gender and country of birth (5.0; 2.3 to 7.8; p<0.001). Paediatricians were also lighter than non-paediatricians (mean weight 70.0v78.0 kg; mean difference 8.0 kg; 3.0 to 13.1; P=0.02) and wore smaller shoes (mean size 6.8 v 8.0 UK; mean difference 1.2 UK; 0.5 to 1.9; P=0.0001). Both of these differences also persisted when adjusted for participant gender and country of birth. There was no significant difference in the head circumference or Body Mass Index between paediatricians and non-paediatricians. ROC analysis suggests that paediatric speciality may be ‘diagnosed’ at a height of 159.00 cm with specificity 92.2% and sensitivity 16.4%.

Conclusion

This study provides the first evidence that paediatricians are physically smaller doctors. The startling implications for targeted recruitment have been discussed.

Figure 1

PRISMA flow diagram of record management during a methodologically limited and completely irreproducible literature review. Image used under a Creative Commons Attribution license and adapted from Moher D et al

Figure 2

Site selection process

*Chief Investigator's wife suggested he “may have better things to be doing”Figure 3

Heights presented by speciality

Table 1

Demographic information, institution, grade and proportion in full time practise, demonstrated by speciality

Paediatrics (n=61)Emergency Medicine (n=57)General Internal Medicine (n=31)Healthcare of the Older Person (n=15)p valueAge median (IQR)40 (35–48)39 (34–43)37 (32–43)38 (36–49)0.781Sex (Male) n (%)26 (42.6)36 (63.2)20 (64.5)7 (46.7)0.078Institution n (%)––––<0.001City Hospitals Sunderland8 (13.1)0 (0.0)0 (0.0)0 (0.0)–King's Mill Hospital6 (9.8)10 (17.5)9 (29.0)0 (0.0)–Queen's Medical Centre18 (29.5)18 (31.6)1 (3.2)0 (0.0)–Royal Derby Hospital11 (18.0)21 (36.8)15 (48.4)4 (26.7)–Sandwell General Hospital14 (23.0)8 (14.0)3 (9.7)7 (46.7)–Tauranga General Hospital4 (6.6)0 (0.0)3 (9.7)4 (26.7)–Grade n (%)––––0.883Consultant34 (55.7)27 (47.4)17 (54.8)9 (60.0)–Registrar25 (41.0)28 (49.1)12 (38.7)5 (33.3)–SHO2 (3.3)2 (3.5)2 (6.5)1 (6.7)–Full Time n (%)46 (75.4)50 (87.7)28 (90.3)14 (93.3)0.087

Table 2

Mean heights of study groups

Mean (cm) (95% CI)All participants (n=164)171.7 (170.1 to 173.3)Paediatricians (n=61)168.0 (165.5 to 170.5)Non-paediatricians (n=103)173.9 (172.0 to 175.9)Emergency medicine (n=57)174.7 (171.9 to 177.4)General Internal Medicine (n=31)173.5 (170.2 to 176.8)Healthcare of the older person (n=15)171.9 (166.2 to 177.6)