Studies of the kind Dr. Anderson has reported are important because of the issues they raise—issues that only time, social change and further study will finally resolve. The issues are both direct and indirect or inferential.
The direct issues apply only to young children who are receiving continuing comprehensive health care from a single medical source regardless of how the source is financed, and to the "routine" examination of such children to discover new somatic conditions in need of care. Dr. Anderson's findings challenge the rigidity of current American health supervision routines. They raise questions, not only about the extent to which other "examiners" can select (not diagnose or treat) children who require the pediatrician's special attention but also about the frequency, content and timing of such examinations, regardless of who carries them out.
The indirect issues are more sensitive and more difficult to deal with. They revolve around the questions which Dr. Webb has phrased so feelingly in terms that will be understood by many pediatricians: the nature of the pediatrician's expectations and the satisfactions he derives from his work; his ability to work with and through others rather than in simple one-to-one relationship; the numbers, training, and roles of other workers associated with him; the relative importance of "routine" physical examinations as compared to other aspects of his work; the acceptability of any change in routines to his patients; and the need to "sell" services in a competitive market subject to greater consumer control.
Statistical projections must always stumble over if's and but's.
The importance of weather and tides on the resuspension and deposition of microphytobenthos (MPB) on intertidal mudflats
