Physical health screening of school-children. Extended health care responsibilities for school-nurses.

. All 410 ten- and twelve-year-old children of a school district underwent two repeated physical examinations within the school services, the first by the school nurse, the second by the school doctor. The aim was to compare their assessments to see if physical class examinations could be delegated to the nurse in future in order to release doctor's time. More than half of the children were found to have slight deviations from normal, most common of the spine and in the skin. The nurse detected many more deviations than the doctor but their assessments showed good agreement concerning functionally important deviations. Newly detected functionally important deviations were noted in 8 children (2%). The routine physical examination could perfectly well be delegated to the school nurse who has the necessary prerequisites to take this responsibility and screen out those children in need of a doctor's assessment, in this study 20%. She would release valuable time for the doctor who could then apply himself to the real health problems of the children of today: chronic diseases, behavioural and school problems, many of which frequently are concerns beyond the boundaries of traditional medical care.