Well-child visits revisited

Abstract

Pediatrics did not emerge as a specialty distinct from other medical disciplines until early in the 20th century. The main causes of death and disease in infancy and childhood during the 18th and 19th centuries--infectious and nutritional diseases--were conquered before midcentury, and primary care pediatric practice was quickly immersed in child health supervision activities. Thereafter, pediatricians spent the majority of their office-based practice time conducting well-child visits. The American Academy of Pediatrics now wishes to increase the number of well-child visits during infancy, childhood, and adolescence by 50%--from 14 to 21 visits. This posture, plus that of recommending ongoing comprehensive and continuing care by a pediatrician for every child, may not be in the best interests of children's health.