During the last year, I have served on an advisory committee that designed, circulated, and collated data from what is called the AAP Periodic Survey of Fellows. The data is not yet ready for publication, but the raw material that is available to our committee provides interesting information for those of us who are concerned about the future of the Academy and its Chapters. The Survey focused on pediatricians' commitment to community-based activities, giving us insight into the amount of time and energy pediatricians are willing to commit to child advocacy activities outside their pediatric jobs. There are several obvious conclusions that can be drawn from the preliminary data:

1.   The majority of pediatricians of all ages and genders are planning to increase the amount of time they spend on community-based/child advocacy initiatives in the near future. 

2.   Most pediatricians are willing to spend 1-3 hours a month on community- based/child advocacy activities. 

3.   Most pediatricians have received no formal training in community-based/child advocacy activities, although the younger pediatricians are more likely than the older pediatricians to have received some formal training.

I am aware of changes in the Residency Review Committee's requirements for pediatric residency programs that will make advocacy education a fixture in pediatric training programs in 2005. This should mean that more young pediatricians will be looking for opportunities to engage in child advocacy activities when they enter academic or community practice. This should add to the pool of pediatricians who would like to become involved in Chapter leadership.

As I continue to struggle with the challenges of finding time to engage in child advocacy projects that, on the surface, do nothing to directly improve the bottom line of my practice, I must admit to myself, and promote to others, the notion that very little of what I do in my office or hospital practice really impacts on child outcomes, if I practice in isolation from the community in which my patients live. It does no good whatsoever for me to rescue some preemie from the gaping jaws of death, only to send that baby home to be neglected and abused by irresponsible young parents who have inadequate parenting education and family support. I must be out there in the community demanding that parents prepare themselves to be good parents before they conceive children that community agencies provide support for inadequate families, and that child care centers, preschools, and schools work with families to assure the optimal growth and development of all our children.

And we certainly must not assume that our only commitment is to our own families and children, for surely they will be mightily affected by the quality of life in the overall community in which we live. Eleanor Roosevelt said it best: "If you care for your own children, you must take an interest in all, for your children must go on living in the world made by all children."

So, in conclusion, the cup is always half-full for us progressive pediatricians. We will find more time to do good work in our communities. We will contribute to the successes of our AAP Chapters that work diligently to make sure that state government adequately supports programs that work at the community level. And we will continue to expect our national AAP to assure that federal programs are designed to work at the state and community level. And there will always be younger pediatricians ready and willing to take on our battles when our child advocacy careers come to an end. But, we should never take any of this for granted!

Dave Tayloe, Jr., MD, FAAP
District IV Chairperson

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