Effective Use of Comprehensive Pediatric Care

THE POOR are demanding that America consider and deal with their problems, social, economic, and medical. America, as a nation, is demanding that the medical profession provide high quality, yet compassionate medical care for all its citizens. While the doctor-patient relationship always has been considered the sine qua non of medical practice, a double standard has developed for low-income families. The care of this group of patients is described as episodic, fragmented, crisis oriented, and anonymous. 1 The absence of a single physician to provide both preventive and curative services precludes the development of any relationship between doctor and patient. In the attempt to supply this need, large scale comprehensive medical care programs for low-income families have been established. These programs are based upon the assumption that such programs inevitably will improve the health of the patients served. The supporting evidence for this hypothesis is at best scanty; the need