Sir.—In response to the article by Dr M. Douglas Baker,1 the American Academy of Pediatrics' Provisional Committee on Pediatric Emergency Medicine applauds the descriptive survey of physician coverage in pediatric emergency departments! This objective analysis has highlighted a short-coming in pediatric training centers.
As Dr Baker commented, emergency department care by unsupervised house staff for children with potentially life-threatening conditions, without on-site attendings, is neither appropriate nor risk-free. Twenty-four hour staffing by knowledgeable, skilled, and interested physicians would undoubtedly improve patient care, resident education, and administrative efficiency.
Physicians with a career commitment to pediatric emergency care are presently too few in number to resolve supervisory lapses. However, the physician who routinely provides care for sick and injured children in an office setting is a valued resource who is currently underutilized. Financial constraints should not prohibit a consolidation of manpower, which, in our opinion, would better assure the care of