EDITORIAL

Put out the "Welcome" mat

It's July. That means that just about 3,000 new pediatricians, including 417 combined internists-pediatricians, are hitting the streets. About 63% are women and approximately 25% (around 750) will, if the recent trend continues, begin training in a pediatric subspecialty. Most of the rest will arrive in your communities, in practices and hospitals.

During the past three or four years, all 3,032 new pediatricians have done things they would never have imagined doing. They've cared for tiny infants and huge teenagers, and they've delivered terrible news about serious illness and death to frightened parents. They've spent sleepless nights admitting sick patients, but they've had enough energy left the next day to explain time-out to the mother of a toddler in clinic. They've negotiated with insurance company representatives about medical services denied to their patients, and they've learned about the paperwork involved in making referrals for patients in managed care. They've seen the tragedy of a shaken baby.

The satisfaction of becoming responsible

This morning, I asked one of our senior residents—a woman who will be joining a group practice in a few weeks—what she most looks forward to about her new life. Before she answered, she acknowledged her bittersweet feelings about leaving fellow residents and her patients in the continuity clinic.

Then she replied, confidently, that she most looks forward to getting to know her new patients with the expectation that they will be her patients for years to come. It's not that she won't be happy to give up in-house night call, or that she won't be glad to have a few more dollars to spend. And it's not that she looks forward to the paperwork and time constraints that come with office practice. It's just that she is now able to distill, from the hassles and sleeplessness of the past three years, the essence of taking responsibility for the health of pediatric patients.

There are 3,032 new pediatricians out there. Most are there because they want to be like you.

Julia A. McMillan, MD, editor-in-chief of Contemporary Pediatrics, is professor of pediatrics, vice chair for pediatric education, and director of the residency training program, Johns Hopkins University Medical School, Baltimore.

Julia McMillan. Put out the "Welcome" mat.

Contemporary Pediatrics

2001;7:9.