outside of the traditional medical system, this means an efficient interface and bidirectional communication with community-based resources is necessary. Last, if any office-based change is to be sustained, third-party reimbursement policies should reflect the importance of these changes.We therefore praise Dr Pavan for her participation in an important learning collaborative. With equally laudable efforts in lobbying for fair reimbursement strategies and pursuing community-specific efforts around the integration of developmental services, we hope that someday children with developmental problems will be better served.