The art and essence of childcare: Personal perspective

Paediatrics is a dynamic specialty because it deals with an evolving, varying size ( 50 kg) and functional maturity of children. The basic aim and goal of paediatrics is to ensure that every child is assisted to achieve his or her optimal genetic potential for physical growth and mental development. A physician must be humane, sensitive, systematic in his approach and genuinely interested in the welfare of children. Paediatricians should approach children as children (not patients) with tact, gentleness, warmth and genuine concern. He must have a scientific bent of mind and use logical systematic steps to arrive at a diagnosis with the help of core knowledge, clinical skills and basic principles. The methods of physicians are like those of a detective, one seeking to explain the disease, the other a crime. Just as evidence is crucial for a detective to identify the culprit, sound evidence as collected by history, physical examination and investigations is of fundamental importance to solve the diagnostic dilemma. After having made a tentative diagnosis, one should prescribe the single most appropriate therapeutic agent, which should be administered in an optimal dose through the most convenient route, instead of instituting a “shot-gun” therapy with half a dozen drugs. We must provide global care to the child rather than a mere cure against a disease process. In order to improve the reach and coverage, there is a need to provide holistic care by harnessing the local health traditions and exploiting virtues of complementary and alternative systems (CAS) for treatment of common day-to-day illnesses. Communication is indeed the key to strengthen the doctor-patient and the doctor-parent relationship. We should be ethical in our dealings with patients/parents and make concerted efforts to resurrect the declining image of the medical profession by promoting the