Few rituals better capture the preventive ethos of pediatrics than does the well child examination. In the United States, 25 to 50% of all general pediatric office visits involve the supervision of routine health care. Yet the same cannot be said for many European countries. In Britain, pediatricians function primarily as hospital-based specialists, with general practitioners and public health nurses providing most preventive care and immunizations. Indeed, an American Academy of Pediatrics (AAP) study of several European countries and Canada in 1990 noted that only a minority of the nations surveyed relied principally on pediatricians for primary care. In the European paradigm, preventive and therapeutic services are frequently administered in separate spheres.
- Received October 23, 1993.
- Accepted February 28, 1994.
- Copyright © 1994 by the American Academy of Pediatrics