I just finished reading the article by Kain et al1 in the December 1996 issue of the Archives and was struck by a sentence in the final paragraph that reflects many of the problems in pediatric surgical patient management. The sentence read "These factors, along with children's cognitive level, should be used to determine which children would benefit most from special attention from their pediatrician and from a preoperative preventive intervention."1(p 1245) Why the pediatrician? Why not the anesthesiologist and the pediatric surgeon, both of whom are responsible for the care of surgical patients, as the providers of special attention? After all, are they not more expert than the pediatrician about what the patient is about to undergo? Perhaps, best of all, would be leadership in anxiety prevention programs by the primary providers of surgical care, anesthesiologists and surgeons, with consultant expertise from pediatricians and parents.
I find it