Special responsibilities: the role of the pediatrician and the goals of pediatric education

Pediatricians provide care to a minority of US children. To some extent this may be a result of organizational features of their practice. This review of the literature suggests that the practice of pediatrics has some attributes of primary care but in other respects it resembles a subspecialty. Pediatricians serve well as a longitudinal source of care for children who identify them as their regular source. As a group, however, pediatricians are not as accessible and available as they might be, probably do not uniformly provide the comprehensive care that they should, and could serve more adequately as coordinators of care. Concern about the extent to which the training of pediatricians addresses the achievement of the attributes of primary care and stresses the recognition and management of primary care problems should stimulate academicians and practitioners to develop a combined and concerted approach to these problems.