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PEDIATRICS Vol. 113 No. 6 June 2004, pp. 1985-1987

COMMENTARY

Mommy, Who Is My Doctor?

Joel J. Alpert, MD, Pamela M. Zuckerman, MD and Barry Zuckerman, MD

Department of Pediatrics
Boston University School of Medicine
Boston Medical Center
Boston, MA 02118

Abbreviations: NSECH, National Survey of Early Childhood Health

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

Mommy, who is my doctor? Every child deserves an answer to this question. We would hope that a parent can respond with the name of the child’s primary care pediatrician, who, together with his or her colleagues, provides the services called for in well-accepted definitions of primary care. The Institute of Medicine has defined primary care as the delivery of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.1 One of us defined primary care >30 years ago (and 2 of us were among the first primary care trainees) as having 4 essential elements: first contact, integration of service, continuity, and family focus.2 Continuity is considered by many to be the most essential component of quality primary health care for children. It provides the low-tech, high-touch, and humane approach to health care that is desired by all.3 Over time, with multiple well and ill encounters with the same physician (known as "continuity"), pediatric patients and their families develop a trusting relationship with their pediatric clinician. This continuous, long-term relationship not only engenders increased patient and clinician satisfaction, but, more significant, increases delivery of preventive measures, increases patient compliance, reduces hospitalizations, and lowers medical costs.4–11

This issue of Pediatrics contains the first reports from the National Survey of Early Childhood Health (NSECH). The data from the study by Inkelas et al12 has yielded a finding regarding continuity that both surprises and distresses us, namely that fewer than half of the parents interviewed for this survey could report that their child sees a specific clinician for well-child care. Therefore, more than half of the children were not receiving continuity of care.

Any relationship requires regular contact to . . . [Full Text of this Article]

Reprint requests to (J.J.A.) 91 East Concord St, 4th Fl, Boston, MA 02118. E-mail: joela@bu.edu




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