Is Standard Practice 'Standard' In Community Pediatrics?

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