In Reply.—I appreciate Dr Winter's thoughts and concerns regarding my recent editorial on the educational values (and limitations) of pediatric resident rotations in neonatal ICUs. However, my brief communication was not intended to be a comprehensive treatise on the "ills of the NICU"; all important and relevant issues could not be covered. However, several of Dr Winter's points require some clarification.
My comments concerning utilization of NNPs was not intended as an admonishment or warning, but to point out that service needs can (and should) be met by health care providers other than residents. Unfortunately, the cost of NNPs must be borne by hospitals (in most cases) as part of the cost of doing business. No doubt, this cost will be passed on to the consumer in the form of higher bills for hospital services. Hospitals must absorb this expense if they and the educational programs they support