Pediatric practice. A. The pediatrician as a specialist.

PEDIATRIC PRACTICE: A. THE PEDIATRICIAN AS A SPECIALIST T lIE BOLE of time pediatrician in the totality of medical practice in timis country undergoes close scrutiny; panels and papers imave dealt witim it. Pediatric educators are vitally concerned timat timeir teaclming programs be tailored to future needs; official interest of the American Academy of Pediatrics lmas been expressed througim its Corntimittee on Medical Education and Subcomnmittee on Postgraduate Education . Now time Academy, jointly witim the American Pediatric Society, time Society for Pediatric Researcim, the American Board of Pediatrics, and time Pediatric Section of the A.M.A., cosponsors a study of Pediatric Research, Education and Practice (PREP) under time direction of Dr. Alex Steigman. I speak now for time practicing pediatrician. Time experiences and philosopimy acquired from a tlmird-centuny devoted to pe(liatnic I)ractice, spanning time lifetime of time Academy, may he of value to timose concerimed with time future of time specialty. Not content to rely on aim individual judgment, I imave submitted time outline of my thougimt to 20 friends of my generation for timein opiimiolms of its validity, timeir experiences afl(l ideas. Timeir responses, entimusiastic and often detailed, enhance and embellisim my oi)servations. Time compositioim of timis group is important, since my timesis relies on timeir approval and added experiences. They practice in 17 states from New England and Florida to California aimd Hawaii; timey live in cities and towns from time size of New York and Cimicago to as small as 2.5,000 on 35,000 population. All are long-time mciiibers of time Academy; many, hut not all, imave held office or served on committees of timis organization. All imave been primarily involved in practice, but many imave had part-time teaciming experience in university or hospital; a few are known for clinical researcim and publisimed articles. This is not a cross-section of pediatrics but a selected panel of timougimtful practicing pediatricians wimo imave an intense interest in time profession and are willing to express timeir ideas. I have not felt qualified to speak for time pediatricians of Canada, Mexico, and the other countries of the Americas, althougim I know many wimose experiences and beliefs parallel ours. I imope timat my observations will stimulate expressions from these several countries. I am certain, after listenung to discussions at time X Intennatiotmal Congress of Pediatrics in Lisbon, timat time stronghold of individualized pediatric practide, as distinguished from time coimcept of collective pediatrics, resides in time Amencas. The practicing pediatrician, as I imave known him over the years, is primarily a specialist in time knowledge and care of infants, children, and adolescents. Out of a background of intensive training, postgraduate education, and experience, he is able to handle most of time problems of acutely ill cimildnen. He can decide rapidly wimetimer time child can be cared for at imome, witim less emotional disturbance and less expense to time family, or vimetimen imospital treatment is needed. He knows the details of hospital care for acute medical illnesses; he is versed in fluid and electrolyte replacement; ime is skilled in applying to time infant and child dozens of diagnostic and therapeutic procedures which may be difficult or impossible for physicians who are accustomed to adults. The pediatrician is depended upon by time surgeon for early diagnosis of acute surgical