PEDIATRICS Vol. 27 No. 5 May 1961, pp. 829-835
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EDUCATION

SOCIAL BIAS IN THE TREATMENT OF PEDIATRIC PATIENTS

Robin F. Badgley Ph.D.1

1 Department of Sociology, Yale University, and Department of Pediatrics, Yale University School of Medicine

Three conclusions are deduced from the results presented.

First, attendance by patients at this pediatric clinic is highly selective by social class and racial backgrounds. Negroes and lower class whites are significantly over-represented. The ratio of Negroes attending the clinic to their expected representation is seven to one. One suspects Negroes may find this clinic more accessible than they do community practitioners. Although the patients attending the clinic are not representative of the community in which they reside, nevertheless they do provide the student with an excellent "testing ground" for future practice. Thus one of the main objectives of the clinic has been achieved.

The second conclusion focuses upon the types of diseases and the utilization of hospital services. Diseases, as would be expected, vary from one service to another. Two per cent of the pediatric ward patients and 4% of the emergency room patients were given diagnoses of psychobiological and psychoneurotic disturbances. In contrast, 25% of the pediatric clinic patients were in these categories.

Dr. Milton Senn believes that pediatric outpatient departments constitute a realistic testing ground for community practice. If this is so, and the prevalence of psychoneurotic disturbances in the community is but a fraction of the figure reported for the clinic, then this finding has broad implications for the treatment of such patients by pediatricians. Referring to the treatment of mentally ill children by pediatricians, Dr. Senn states:

The ordinary paediatric staff, even with some psychologic insight, is usually not trained well enough to cope with these children. In order to deal with them properly, psychiatric rather than paediatric hospital services are needed.