Primary Care Pediatrics II

Although the overwhelming majority of kids I saw were healthy, I did see a few children with chronic diseases. I saw a newborn with a striking hypopigmented periorbital rash which turned out to be neonatal lupus. I also met an incredibly loving and supportive family of a nine year old boy with Down syndrome. I learned a lot about what it's like to have a chronic disease in childhood and the impact it has on family and friends. Medically, I was able to review the clinical features of Down syndrome and its implications on future health. Similarly, I learned quite a bit when I met a child with sickle cell anemia.

I was talking to one of my classmates who was less enchanted about primary care pediatrics. One question that was brought up was whether these visits were important or necessary. For the most part, these kids are healthy, thriving, and happy. Many of them are only here for vaccinations. Yet they take up a decent amount of health care resources; the clinic is always overflowing and physician time is precious. Do kids who get routine pediatric care do better than kids who do not? I'm not sure, and I actually think it's an interesting and worthwhile question. Certainly, we would like to think that people plugged into the health care system do better, but given a population which is so healthy in general, what is the cost-benefit analysis?