This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (12) Citing Articles via Google Scholar Google Scholar Articles by Cheng, T. L. Search for Related Content PubMed PubMed Citation Articles by Cheng, T. L. Related Collections Related AAP Red Book topics: Anthrax Social Bookmarking                         What's this?

Primary Care Pediatrics: 2004 and Beyond

Division of General Pediatrics and Adolescent Medicine
Johns Hopkins University
Baltimore, MD 21287
Department of Population and Family Health Sciences
Bloomberg School of Public Health
Baltimore, MD 21205

The first 300 words of the full text of this article appear below.

Changes in medicine domestically and globally are transforming primary care in the United States. Many have suggested that primary care is in crisis or at least at a crossroads in the United States. The Annals of Internal Medicine recently devoted much of one issue to this topic.¹ Primary care for children and adolescents, however, was not addressed specifically. This article focuses on pediatrics and identifies potential roles and new models for primary care pediatrics. The Institute of Medicine has defined primary care as "the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community."² Starfield³ has defined 4 attributes of primary care including first-contact care, longitudinality, comprehensiveness, and coordination. September 11, 2001, the anthrax scare, and emerging threats such as severe acute respiratory syndrome (SARS) have brought a new focus on the importance of individual-level contacts in addressing population-level threats. Before these world events, however, primary care pediatrics was already grappling with its identity and responding to significant changes in medical systems, science, and family needs. The pace and scope of these changes are such that primary care pediatricians of the future will not be performing the same role as today.

Historically, American medicine has tended to be reactive rather than proactive in defining its roles in society. However, dynamic change demands collective reflection; it is time to be proactive in assessing the needs of patients, exploring potential roles as health care providers, and developing the mechanisms to redefine the primary care pediatrician of the future.

	HISTORICAL PERSPECTIVE

 
Projecting future trends requires reflection on the history of the profession of preventive pediatrics. In the 1800s, few physicians in the United States routinely treated children; mothers . . . [Full Text of this Article]

Address correspondence to Tina L. Cheng, MD, MPH, Johns Hopkins University Department of Pediatrics, 600 N Wolfe St, Park 392, Baltimore, MD 21287. E-mail: tcheng2@jhmi.edu

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				Innovation in Residency Education and Evolving Pediatric Health Needs Pediatrics, January 1, 2010; 125(1): 1 - 3.

				J. L. Tanner, M. T. Stein, L. M. Olson, M. P. Frintner, and L. Radecki Reflections on Well-Child Care Practice: A National Study of Pediatric Clinicians Pediatrics, September 1, 2009; 124(3): 849 - 857. [Abstract] [Full Text] [PDF]

				M. D. Jones Jr, G. A. McGuinness, L. R. First, L. K. Leslie, and and the Residency Review and Redesign in Pediatric Linking Process to Outcome: Are We Training Pediatricians to Meet Evolving Health Care Needs? Pediatrics, January 1, 2009; 123(Supplement_1): S1 - S7. [Abstract] [Full Text] [PDF]

				G. Lister, T. C. Murdock-Vlautin, and A. L. Friedman Report of Colloquium I: The Future of Pediatric Health Care Delivery and Education--Pondering Imponderables to Create an Ideal Residency in a World of Critical Uncertainties Pediatrics, January 1, 2009; 123(Supplement_1): S12 - S16. [Abstract] [Full Text] [PDF]

				L. K. Leslie What Can Data Tell Us About the Quality and Relevance of Current Pediatric Residency Education? Pediatrics, January 1, 2009; 123(Supplement_1): S50 - S55. [Abstract] [Full Text] [PDF]

				C. DeLago and E. Gracely Evaluation and Comparison of a 1-Month Versus a 2-Week Community Pediatrics and Advocacy Rotation for Pediatric Residents Clinical Pediatrics, December 1, 2007; 46(9): 821 - 830. [Abstract] [PDF]

				M. Y. Mann, M. A. Lloyd-Puryear, and D. Linzer Enhancing Communication in the 21st Century Pediatrics, May 1, 2006; 117(5/S1): S315 - S319. [Abstract] [Full Text] [PDF]

				J. Goldhagen Integrating Pediatrics and Public Health Pediatrics, April 1, 2005; 115(4/S1): 1202 - 1208. [Abstract] [Full Text] [PDF]

				P. H. Wise The Transformation Of Child Health In The United States Health Aff., September 1, 2004; 23(5): 9 - 25. [Abstract] [Full Text] [PDF]