The Pediatric Generalist and Integrative Care

One of us attended a recent meeting at which it was proposed that the generalist pediatrician should become a consultant and that primary care—which, according to the discussant, involved such issues as provision of immunizations—be the task of other health care “providers.” We appreciated the perspective from which that comment flowed—it was an attempt to redefine what the generalist pediatrician can best do. But the remark led us to consider whether the terms primary care physician and generalist physician capture and reflect what the pediatrician currently does and will in the future be called on to do. In the recent past, Dr McCarthy visited a relative who was ill with terminal cancer and also with musculoskeletal and pulmonary disease. The patient told him about the complex care that was focused on each organ system and concluded by saying she had a doctor to care for her cancer, her lung disease, and her musculoskeletal problems. She then paused and … Reprint requests to (P.L.M.) Section of General Pediatrics, Department of Pediatrics, Yale School of Medicine and Yale-New Haven Children’s Hospital, 333 Cedar St, P.O. Box 208064, New Haven, CT 06520. E-mail: paul.mccarthy{at}yale.edu