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June 1977

The Child Health Associate

Author Affiliations

School of Health Services The Johns Hopkins University 624 N Broadway Baltimore, MD 21205

Am J Dis Child. 1977;131(6):627-628. doi:10.1001/archpedi.1977.02120190021002

The complexity of what has been deprecated as a "nonsystem" of health care (but should perhaps be better viewed as a Rube Goldberg perpetual motion machine) is unyielding to any "quick fix" despite the universal desire for improvement and the presumed consequence, better quality of life. Instead of simplistic answers, thoughtful scholars, experimenting with crucial elements in the system, are engaged in painstaking, long-term investigations that are beginning to show that slight manipulations disproportionately effect great change. Such is thought to be the case with health manpower.

This first decade of tentative starts in educating nonphysicians (who can diagnose and treat while they attend with equal devotion to the psychosocial aspects of the patient's life situation) has seen what is probably the initial growth spurt in the development of "physician extenders," HEW-ese for child health associate, nurse practitioners of various special designations, MEDEX, physician's assistants, health associates, PRIMEX, and