Diagnostic exposure in a primary care clinic during pediatric training

A retrospective and descriptive study was done in a general pediatric training site with the purpose of identifying the diagnoses to which the trainees have been exposed, as well as the changes in the pattern of these diagnoses. The number of patient-doctor contacts, type of patient visit, and frequency of diagnoses were compared. A total of 66,054 patient-doctor contacts occurred during the years 1979 to 1989, comprising 79.6 percent scheduled health visits and 20.4 percent emergency visits. The main diagnoses were: healthy child/adolescent (HV), well baby (WB), upper respiratory infection, skin diseases, bronchial asthma, acute gastroenteritis, otitis media, anemia, incomplete immunization, psychosocial problems, nutritional/linear growth problems, psychosomatic disturbances, parasitosis, and pneumonia. There was a significant decrease (P < .005) in the diagnosis of infectious diseases and a significant increase (P < .005) in the proportion of WB and HV. The latter were the two most common diagnoses in the year 1989.