This book provides an important perspective to new parents on what to look for in a pediatrician, and to young pediatricians starting out, it will answer many "how to" questions.
This practical and useful book is designed to bridge the gap between a pediatrician's medical school and postgraduate training and his entry into private practice. It is not merely a handbook on office design and procedure, although it treats these subjects in some detail. It is primarily a thoughtful presentation of the authors' personal style of pediatric practice, oriented toward normal child development and preventive care. In addition to elaborating on the mechanics of their practice, the treatment of routine self-limited childhood illnesses and injuries, and important medical techniques, the authors also discuss the most effective way to deal with consultants, social agencies, and schools.
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This broad perspective of a pediatrician’s mission is reflected in the preface to the book, in which the authors state, “We are encouraging our patients to stay with us longer and we are spending more time with adolescents and even young adults.” Bass and Wolfson further note that pediatricians are playing a more central role in healthcare in general. Today’s pediatrician must keep pace with the latest medical issues and topics, and be prepared to deal with expanded patient relationships and treat a greater variety of patients. Nonetheless, authors recognize that, “the fulcrum of any pediatric practice is [still] the newborn baby.”
As an example of the more expansive mission that pediatricians must now be prepared for, the authors point out that, unlike in years past, the care and treatment of older children may entail genital exams and discussions of sexual matters. Also, as many readers are undoubtedly aware, contemporary pediatricians, more so than earlier generations, must be alert to and capable of diagnosing a variety of psychological and emotional conditions of older children, such as attention deficit disorder and substance abuse. In their expanded role, pediatricians must work with medical professionals in specialized areas such as psychology, with teachers and others at schools, and with personnel who provide community services for younger persons.
Bass and Wolfson’s book begins with the premise that, to get a new practice off on the right foot, a pediatrician must first understand the mechanics of setting up an office, which, in turn, is inextricably bound with his or her style of practice. In other words, pediatricians need to recognize the interrelation between the mechanics of the office – that is, its arrangement or design – and their personality and the standard of care they intend to provide as physicians. Thus, the design of a small pediatric facility implies a standard of care the pediatricians mean to provide. Another important consideration, which the authors weave into the discussion, is aligning the pediatrician’s mechanics and style with what constitutes prudent business practice.
The book is, however, more than a “how-to” on setting up a pediatric practice. Bass and Wolfson never stray from their objective of helping beginning pediatricians meet the demands of today’s world. In doing so, the authors introduce topics that otherwise might be overlooked by beginning pediatricians. For instance, on the subject of play areas, the authors do not simply mention it as a necessary adjunct of a pediatric office, nor do they merely include it as an item on a checklist. Rather, Bass and Wolfson discuss the purpose of the play area, its value to patients and the pediatrician, and how it is used in the daily operations of the practice. With these considerations in mind, the authors advise the pediatrician to ensure that the play area is part of the waiting room so parents can keep an eye on their children. This, in turn, requires that the waiting room be especially large, not only to include the play area, but also because “pediatric patients tend to have lots of company – sometimes both parents or grandparents or friends.” An inviting play area is also important because it will “distract the children...while you have a private word with their parents.”
The design of a pediatric practice must also take into account the various medical procedures that will be performed on patients. For example, the authors suggest that, “In examining the eye you attempt the fundoscopic exam without touching the face...In examination of the ears learn to stand with your eye at arm’s length from the otoscope.”
Most importantly, the authors tackle the topic of delivering healthcare to patients of diverse ages and needs. They discuss for example, what office behavior to expect from children of all ages, which can even vary from month to month for patients of the same age. Managing a patient from registration to receiving payment is another topic that is concisely and knowingly covered.
Style and Management of a Pediatric Practice provides a comprehensive, concrete, informative handbook on implementing the best medical and business practices for the smaller pediatric practice. The authors advocate their particular “system” and beginning pediatricians may conclude they want to modify the authors’ advice, but they will find it unfailingly provides a good starting point. This work can help novice pediatricians quickly hit the ground running without expending unnecessary time and energy that is better used on treating patients.
Leo W. Bass, M.D., and Jerome H. Wolfson, M.D., were prominent pediatricians in the Pittsburgh area for many years. Besides operating their own pediatric practice, they have consulted, taught, and provided services for local medical facilities
The late Lee W. Bass was the founder of Bass Wolfson, one of the premier pediatric and adolescent medical practices and a revered community pediatrician in the Pittsburgh area.
Jerome H. Wolfson, MD, FAAP is a practising doctor at the Squirrel Hill Office of Bass Wolfson Pediatrics. He obtained his college and medical degrees from State University of New York Downstate Medical Center College of Medicine, in Brooklyn, NY. He is currently a Clinical Professor of Pediatrics at the University of Pittsburgh School of Medicine, certified by the American Board of Pediatrics. He was the Director of Pediatrics at Hazelwood Health Center & Greenfield Medical Center; Attending Pediatrician, Children's Hospital of Pittsburgh Diabetic Clinic.