The Rebirth of Pediatrics
2008; American Academy of Pediatrics; Volume: 123; Issue: 1 Linguagem: Inglês
10.1542/peds.2008-3254
ISSN1098-4275
Autores Tópico(s)Ethics and Legal Issues in Pediatric Healthcare
ResumoAny close examination of the epidemiologic trends in childhood suggests 2 fundamental findings. First, pediatrics has been among the most successful specialties in the history of modern medicine. Second, pediatrics must change. At the heart of this seeming paradox is the recognition that pediatrics has so altered the clinical threats to the well-being of children over the past 50 years that new structures of care will be required. The epidemiology presents a ruthless logic: one cannot take pride in pediatrics' remarkable record of impact and at the same time defend the status quo. The challenge to the pediatrics community is to ensure that the changes that will inevitably come are exquisitely focused on meeting the needs of children. We must craft strategies that can protect what remains essential in pediatric practice and yet embrace a historic opportunity to craft requisite reforms. It is in this context that the recent initiatives by the American Board of Pediatrics1 [Editor's note: also see related supplement titled “Residency Review and Redesign in Pediatrics: New (and Old) Questions” with this issue of Pediatrics. ] and the American Academy of Pediatrics2 to consider new training and practice needs should be welcomed. However, the nature and scale of the challenge will require a new level of direct engagement from pediatricians and a renewed progressive commitment to speak with a stronger and more coherent collective voice. It is useful to begin by recognizing just how much the epidemiology of childhood has changed over the past several decades. The likelihood that a child will get an acute illness, such as an upper respiratory infection, otitis media, or viral syndrome, has not changed very much over this time period. However, the likelihood that a child will get an acute illness and stay home from school has decreased dramatically. … Address correspondence to Paul H. Wise, MD, MPH, Stanford University, Center for Policy, Outcomes and Prevention, Department of Pediatrics, CHP/PCOR, 117 Encina Commons, Stanford, CA 94304-6019. E-mail pwise{at}stanford.edu
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