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Is Standard Practice 'Standard' In Community Pediatrics?

Am J Dis Child. 1990;144(1):11. doi:10.1001/archpedi.1990.02150250013002.
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Sir.—I consider my medical training to have been divided into three parts. The first period was the education and experience I received before medical school and residency (BMSR), the second was during medical school and residency (DMSR), and the last was after medical school and residency (AMSR). Each period provided a unique perspective, but was not complete in itself.

My medical training experience was a sheltered world where an aversion to the acute embarrassment of having the chief resident point out a flaw in my workup resulted in a compulsion to order extensive and generally uninformative batteries of tests for even the simplest of problems. It took 2 years after leaving my residency program for me to decompress from this environmentally induced paranoia.

Of course it did not surprise me that 65% of AMSR pediatricians would not order roentgenography on an asymptomatic child who had swallowed a coin. The


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