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ABSTRACT. This policy statement reaffirms the pediatrician's role in community pediatrics. It offers pediatricians a definition of community pediatrics and provides a set of specific recommendations that underscore the critical nature of this important dimension of the profession. Pediatrics 2005;115:1092-1094; community, pediatrics, pediatrician, role of, definition of, profession.

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Access to primary care doctors has been shown in studies across the world to result in better patient outcomes, increased satisfaction with care and lower health-care costs. Primary care is the entry point for most patients into the health-care system and focuses on prevention, chronic care management and availability for sick care. Primary care offices providing continuous, coordinated and accessible care are called medical homes. Changing disease patterns and increased amounts of chronic care has increased the importance of primary care medical homes to the health and well-being of patients. In the USA, however, fewer medical school graduates are entering primary care specialties such as pediatrics, family medicine and internal medicine, and the existing workforce is diminishing as primary care doctors retire as a result of overwork and poor job satisfaction.

Recent leaps in the understanding of early brain growth and child development provide us with scientific underpinnings for strategies to improve child health outcomes. Genetic, environmental, and behavioral factors impact the growing child and have a profound impact on lifelong health and function. Recent advances in knowledge concerning the biologic underpinnings of brain development provide a better understanding upon which to base interventions. All growing children experience stress. However, if children are stressed in a manner that exceeds their coping capability, the stress is considered toxic. Toxic stress can impede the cognitive and social emotional growth of the developing brain. Pediatricians have the opportunity to intervene through screening for families at risk, supporting optimal parenting, and linking in a team fashion with other providers of care for young children to support development.