Advisory Committee Perspective

Abstract

There is no question that the world of children—and thus, that of Pediatrics—has changed in the 20 years since I graduated from medical school. Then, heading off to my internship and training in Pediatrics, medical (ie, scientific) issues still were paramount and costs were no object; we could admit a child for a fever of unknown origin and do a lengthy and thorough workup that provided an educational experience for the residents while also, hopefully, discerning the child's illness and appropriate treatment. Since then, of course, two things have changed mightily: psychosocial and behavioral issues have become more significant factors in Pediatrics, the “new morbidity” so aptly coined by Robert Haggerty, MD1; and financial constraints attendant to the pervasiveness of managed care have severely restricted the hospitalization and performance of elaborate testing on patients. Luckily for us and for our patients, we at the same time have mastered many common childhood illnesses, so that most patients can be treated safely on an outpatient basis. As I like to describe it, we have mastered the science of Pediatrics and now must focus on the art of our specialty, the fuzzy parts around the edges. When I first learned of the Community Access to Child Health (CATCH) Program, I was working in a community health center in northern Illinois, doing outreach into the community and teaching medical students general pediatrics. Because of my other role, that of president of the Dyson Foundation (then a part-time job), I was …