SEVERAL months ago I had the privilege of visiting Winnipeg, in Saskatchewan, Canada, at the invitation of the Academy Chapter there, to address the 52d annual meeting of the Children's Hospital. My talk at the meeting was an effort to answer the question: "What lies ahead for children's hospitals?" I know that many pediatricians and others, much more experienced in this complex subject than I, are seeking the answer. Perhaps exposing you to some excerpts from my Winnipeg talk will stimulate discussion of the future of this important factor in child health.
The progress made in the care of children in general hospitals and the strengthening of pediatric service in university medical centers raises the question: "Do we need special hospitals for children?" Dr. J. W. Gerrard, Professor of Paediatrics at the University of Saskatchewan, in a recent letter to me sums up the case for children's hospitals very well. He says:
1. Children's hospitals set the standards of treatment, care and investigations for routine pediatric problems. There is no doubt, for example, that acute infantile gastroenteritis is handled very much more efficiently in a children's hospital by pediatricians than in a general hospital where children are cared for, possibly by pediatricians, but more probably by general practitioners. Not only will the treatment be better in the children's hospital, but the children's hospital will be to an advantage because its services, and in this particular, its biochemical services, will be tailored to meet the needs of children; analyses will be carried out on small amounts of blood, not on the large quantities required by laboratories dealing mainly with adults.
2. A children's hospital is advantageous because not only do perplexing problems, but skilled pediatricians as well, tend to gravitate towards it, and there is always the opportunity, should the need arise, to call in colleagues in consultation.
3. In a children's hospital, common problems tend to be grouped together, e.g., children with leukemia, heart disease, nephrosis and so on, providing the opportunity for pediatricians to specialize in a particular field; they then gain experience which helps to raise the standards of treatment and research in these fields.
4. A children's hospital provides students and interns with a chance to review all or most pediatric problems within a relatively short span of time, so that when they go out into practice they will be able to recognize the rare and the strange, for they will be seeing diseases which they have already had a chance to study and treat.
5. Children's hospitals provide excellent centers for the dissemination of new knowledge to those in practice, particularly at so-called "refresher courses," and in this way keep those in practice up to date.
A CHILD UPCOUNTRY DOCTOR - BY THE LABOR AND MERCY OF GOD
