Sir.—Having spent the last seven years as a primary physician with Indian Health Service, I read with interest DiNicola's1 letter on neglected and abused children on Indian reservations. It is unfortunate that, due to the loss of the National Health Service Corps scholarship program, the influx of concerned, competent young physicians like Dr DiNicola that program brought to the reservations will now end. However, while I applaud his obvious compassion toward the plight of Indian children, I think the issue is even more complex than he states.
Certainly a problem exists. I take issue, however, with the statement that the extended family no longer is a factor on modern reservations. My experience is that not only is this method of child rearing alive and well, it may be a norm on many reservations. I have been impressed that it is successful in many cases.2 It is important
CALVERT JF. Approaches to Child Abuse on Indian Reservations. Am J Dis Child. 1986;140(9):850-851. doi:10.1001/archpedi.1986.02140230020006