To the Editor.—

What a shame that Dr Young calls into question the very concept of teaching residents how to bill for their services.

As the head of a large pediatric group, I have the opportunity every year to review the credentials of recent pediatric residency graduates. They are all ignorant of billing, of course. Their knowledge of practice organizational forms is sketchy. Their half-day-a- week continuity clinics have ill-prepared them for their chosen life of office pediatrics. ADHD? Behavioral assessment and advice? Speech and language assessments and disorders? Family dynamics? These everyday subjects for those of us in practice have only been addressed in a cursory manner in their residency experience. Of necessity they will all undergo on-the-job training.

Contrast this to their well-developed skills with bone marrow transplants and cancer, very low birth weight neonates, and a plethora of conditions they will meet once or twice in...

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