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October 17, 1986


JAMA. 1986;256(15):2057-2059. doi:10.1001/jama.1986.03380150067012

Pediatrics is undergoing intense self-examination. The issue is whether the discipline should include primary care within its functions.1-4 On the one hand, there are those who feel that "ordinary" pediatric care should be delegated to physicians and nonphysicians in other disciplines, most notably family practice and the allied health professions. Proponents of this viewpoint believe that pediatricians should concentrate on secondary (consultation to those providing primary care) and tertiary (specialty consultation) functions. Arguments cited include the need for nonmedical interventions in primary care; the fact that the child lives within a family and is better served by a family-oriented practitioner; the consideration that compensation will focus on payment for "ordinary" services by the least expensive health care provider; the fear that the best students will not care to enter a "mundane" spectrum of practice; and the possibility of overtraining pediatricians for the roles they now perform. Pediatricians who argue