Citation

Rivara FP, Fan MD. JAMA Pediatr. 2017; 171(8): 723.

Copyright

(Copyright © 2017, American Medical Association)

DOI

10.1001/jamapediatrics.2017.1145

PMID

unavailable

Abstract

Well-child visits are a staple of pediatric practice. It has been known for many years that physical examinations of healthy children who are well known to a pediatrician contribute little new information. Thus, the most important part of the allotted 15 to 20 minutes is answering parents' questions and providing anticipatory guidance on the developmental and behavioral issues that are likely to arise in the interim before the next visit.

The obvious question is what topics are the most important to discuss. A favorite article is the Belamarich et al "Drowning in a Sea of Advice: Pediatricians and American Academy of Pediatrics Policy Statements" from 2006.1 The authors reviewed 57 American Academy of Pediatrics policies relevant to the general pediatrician. These policies contained 192 different advice directives that the pediatrician was supposed to deliver to parents during well-child visits during the course of childhood. There are clearly not enough hours in the day or minutes in the well-child visit to accomplish this. How is a pediatrician to decide on which directives to focus and with which not to bother?

Language: en