—Dr O'Halloran points out that the New York State Health Department may be on the wrong track in using frequency of newborn clavicle fracture as a guideline for quality of care. By and large, we think he may be correct. In addition, the requirement for reporting newborn clavicle fractures in New York State may lead to unnecessary documentation and costs without any effect on the quality of care.
Dr O'Halloran also points out that the only reason to diagnose newborn clavicle fractures would be to explain symptoms, such as unexplained irritability. Another reason to diagnose newborn clavicle fractures is to prevent embarrassment at the first office visit when a large callus is felt covering the healthy broken clavicle. Additionally, we would prefer to make the diagnosis rather than to have the parent bring the callus to our attention on or before the first visit.