PEDIATRICS Vol. 14 No. 5 November 1954, pp. 547-556
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EDUCATION

TEACHING COMPREHENSIVE PEDIATRICS IN AN OUT-PATIENT CLINIC

ALBERT J. SOLNIT M.D.1 and MILTON J. E. SENN M.D.1

1 The Department of Pediatrics and the Child Study Center of the Yale University School of Medicine, New Haven.

Editors: GROVER F. POWERS, M.D..

1. The out-patient clinic is the most valuable place for the physician to learn how comprehensive pediatrics can be mastered in his every-day office and home-visit practice. It is also the logical place to teach the relationship of community resources to pediatric practice.

2. Comprehensive medical care of the child is defined as the prevention and treatment of physical disease, and the supervision of healthy growth and development, physical and psychological. Through his comprehension of physical, psychological and social forces that influence the child, the pediatrician enables the child and his family to take an active role in solving their health problem.

3. The interview should serve as a basic instrument of diagnosis and treatment. It should be flexible, and enable the patient to express fears, anticipations and questions about his symptoms. It should be practical in length of time and sequence, depending on the patient's symptoms and his reactions to being examined by the doctor.

4. The attitudes necessary for the practice of pediatrics are best acquired by the student through the demonstrations of his teachers and through his professional identification with them.

5. When pediatric teaching is focussed on the patient as a person, a student learns that:

a) Every patient is an interesting person. It can be as satisfying and important to care for a six-week-old infant who is well or a child who is going to camp, as one who suffers from a rare disease.

b) There is no such thing as a non-contributory family history. It is necessary to know the meaning that complaints or questions have for the mother and the child. This can only be obtained through the physician's expressed interest in both, and in his patient attitude and willingness to listen to what both have to tell him.

c) The physician is faced with a patient (child) who is extremely dependent on parents or parental figures. The parents and child form a unit. It is the pediatrician's goal to help improve the health of the child by understanding the child's position in the unit. He should utilize the assets of this unit for the child and parents.

d) His interest in and acceptance of the patient results in more effective diagnosis and treatment. This attitude develops gradually when adequate supervision is available.

Submitted on July 28, 1954




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