"What is it that you find so satisfying after four decades of pediatric practice?" asked Dr Howard Spiro, Professor of Medicine, at a recent seminar in the Program for Humanities at Yale. I appreciate the opportunity to share my answer with readers of Pediatrics in Review. I practice primary pediatrics in association with Dr Robert LaCamera and Dr Robert Anderson in New Haven, Connecticut. I find that providing primary care from infancy through adolescence offers a satisfying opportunity to serve both parents and children. In our practice, we consider that the primary physician is the first contact with the health care system.