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Re: Economics of Office Practice

In a message dated 7/3/1998 11:29:08 PM Eastern Daylight Time,
 writes:

> I ran across a paper which stated that one-third of all illness visits to
the
> office based pediatrician result in a diagnosis of otitis media. I would
> guess that all varieties of URI's are seen regularly as well. I wonder if
> these minor problems account for most of the pediatricians work load. Any
> comments?

I'm not sure if it's as high as one-third, but we do see a lot of ear
infections.  Yes, most of our workload consists of "minor" problems and well
checkups--but try telling a mom that her kid's screaming at 3AM is a minor
problem!  The real problem comes in finding the occasional serious problem
when it presents just like the last dozen minor ones, and not over-reacting to
those minor problems that may present like serious ones.  We see many kids
whose presenting complaint is headache, stiff neck, fever and vomiting.  But I
haven't seen a case of meningitis in a long time.  Similarly, we see a lot of
kids with abdominal pain and vomiting, but only a few have appendicitis.  I
could go on and on, as I'm sure most of those in private practice could.  We
do deal with mostly minor complaints, but it's still a challenge, and
sometimes even fun!

Moshe Adler, MD