Sir.—The editorial by Dr Helfer1 about primary care and related issues needs to be challenged. In its first
section, "Primary Care: A Means to an End?" a question is posed: "When pediatricians provide primary care, are they practicing their specialty or making a living, thereby permitting them to practice their specialty at a later time?" His answer discusses this problem from the focus of the pediatrician. He sees it "as it is, ie, a means to an end, a way to make a living on our fee-for-service system...."
Pediatrics is, first and foremost, primary care of children. It is the daily humdrum attention to all sorts of problems, many of which the pediatrician believes to be trivial and mundane. But these problems are not trivial and mundane to the child and the child's family who need attention. They believe these problems to be important or they would not