Community paediatrics: Soft science or firm foundations?

Abstract

: Community paediatrics strives to integrate the biology of health into the social and psychological worlds within which children grow and develop. Consumer demand for limited community paediatric clinical services is increasing and medico–legal pressures escalate professional and personal concern. Meanwhile, the profession, through training and professional support, has struggled to keep up. Research into community paediatrics and its integration into policy and clinical practice remains limited, raising the perception that it is a ‘soft’ science. Our viewpoint is that necessary progress in this field requires leadership, apprenticeship and research. We argue that to build firm foundations for the future requires structures to enable clinical specialisation and continuing professional development in this area.

Neurodevelopmental and behavioural paediatrics

“…Quantitative research such as randomised clinical studies are difficult in CCH and Neurodevelopmental Behavioural paediatrics because of the complexities noted above. The two journal structures of Viewpoint and Editorial Comment have allowed expression of opinion where data is difficult to obtain. This in turn has allowed exchange of ideas and the generation of discussion that has been important to the development of this field.…”

Community child health in Australia: The road ahead

“…Smith and McDowell, in a viewpoint published in this issue of the Journal 1 have thrown a rock into a reasonably quiet pond by calling for major changes in the organisational structure of community child health in Australia. In a purposefully provocative paper, they have detailed a number of challenges facing community child health – the perception that it is ‘soft’ and does not have a rigorous academic base; the diversity and variable quality of training; the lack of any monitoring of practice standards; and the poor funding base for clinical work and research in the area.…”

“…As Smith and McDowell imply, the traditional separation of hospital and community paediatrics is no longer appropriate. Community paediatrics ‘envelops every aspect of traditional paediatric medicine’ 1 . Community paediatricians have had, and will continue to have, an important role in influencing the culture of paediatric institutions, as well as in the training and practice of general paediatrics.…”