The field of pediatrics is a unique profession within medicine. Pediatrics is one of the few specialties that is officially designated with a dual role: that of being primary and specialty physicians simultaneously. One good thing that has come from health maintenance organizations is the recognition that general office-based pediatricians can be primary providing physicians and specialty consultants for patients. It opens a whole new arena of coding when you begin to consider yourself potentially as a specialty consultant. I am referring not to subspecialty pediatricians (eg, pediatric cardiologists, infectious disease specialists, renal specialists, etc) who have always been considered consultants, but to the general office-based pediatrician who sees 30-plus patients each day divided between well checkups and sick visits.

How many of you have received phone calls or referrals from family practitioners in the area about their more complicated pediatric patients? It does not happen too often, but when...

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