'Paternalism' and Primary Care-Reply

In Reply.—Dr Owens' letter highlights several interesting points. First, we agree with her and Dr Green that excessive dependence upon health care providers may be a common phenomenon in the setting of private practice. The focus of our article upon the public clinic was borne of our professional experience and was not meant to imply that similar patterns of care do not often exist in the private sector. Second, Dr Owens identifies the basic weakness in the commentary of Drs Richmond and Kotelchuck. Their remarks suggest a liberalism not sure of its own objectives. On one hand they agree that "Helping children and parents assume and maintain responsibility for their own health care needs is a legitimate concern." On the other hand, they accuse us of "abandoning" and "blaming the victim" when methods are proposed for achieving this goal. "Blaming the victim" hardly seems an appropriate label for a