In Canada, the term ‘community paediatrics’ is most commonly applied to the private office-based primary care or consultant practices of paediatricians. Similar terms are used in public health and in academic or research programs such as social paediatrics, population paediatrics or global paediatrics. The conceptual elements of community paediatrics are embodied in working models such as those created by Haggerty and his Rochester (New York, USA) team. Haggerty’s 1968 article in the New England Journal of Medicine outlines the principles that inspired and guided the Rochester program. Although that article was published 40 years ago, it continues to have relevance for the careers of today’s paediatricians.
At one time, all childhood illnesses were treated in the community during home visits by generalist physicians. As paediatric care evolved, it became more hospital-based but, as Kenneth Roberts reminds us, “fewer than one quarter of hospitalized children are in children’s hospitals”. Today’s paediatric inpatient units admit fewer and fewer of the common childhood illnesses and even fewer adolescents. Their focus is on complex cases with higher acuity. Usually, their programs are weakly connected to the broader community of generalists in paediatric practice. Paediatric hospitals have become complex organizations providing a highly specialized technological treatment focus. These developments have been at the expense of Haggerty’s concern for the health care needs of all children and youth. What was once a focus of mainstream paediatrics has become a focus for others, such as community medicine specialists in family practice and those in public health. You can shop with a reliable pharmacy – http://birthcontroltab.com/ to pay less for high quality.