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Every school needs a doctor, pediatricians say

By Andrew M. Seaman

NEW YORK (Reuters Health) - Despite no federal or uniform state requirements to do so, all school districts should have a doctor to oversee school health services, according to a policy statement from a group of American pediatricians.

"Our hope is that a policy statement like this will start to get people talking," said Dr. Cynthia Devore, a co-author of the statement from the American Academy of Pediatrics (AAP).

"New York - and the northeast in general - tends to spell out in legislation that school districts shall hire a medical director to oversee health services," she told Reuters Health. "That's ideal. It should be legislated, but not every state does that," said Devore, a board-certified pediatrician in Rochester, New York.

The statement published in the journal Pediatrics on Monday encourages pediatricians to "advocate that all school districts should have a school physician" and their roles should be "well defined, fairly compensated and outlined in a written contract."

Basically, Devore said, the group recommends having a doctor in every school district and a nurse in every school.

The American Medical Association also recommends that all schools have a nurse to provide healthcare and have a doctor available on a regular basis.

School doctors are not a new concept. In fact, the statement says, they have been around since the 1800s, and Devore said they are one of the oldest groups within the AAP.

But the roles of school doctors depend on the school district's needs.

"Some physicians are hired by schools and have full-time jobs… Some physicians might be a consultant," said Devore.

In addition to being full- or part-time employees and consultants, the statement says doctors can play a role as an independent contractor or a volunteer on a school health advisory group.

Ideally, the doctor should have an expertise in pediatrics or be a board-certified pediatrician, according to the statement.

The group says it's critical the doctors know about, among other things, disease outbreak control, risk management, immunizations and sports medicine.

Previous studies have found that having a school doctor is linked to better attendance for some students, especially those with chronic health conditions like asthma.

"Because states fund schools on a basis of student attendance, a school physician can potentially save schools money by decreasing absenteeism through advocacy and education," the statement says.

It also suggests doctors can save school districts money by preventing costly litigation through better health services and protocols.

"Unfortunately when budgets are tight, money is short and education jobs are at risk, some people view health services as an expendable cut, and we don't see it that way," Devore said.

SOURCE: http://bit.ly/HjQ8dI Pediatrics, online December 31, 2012.

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