Calculating a Clinic's Childhood Immunization Rate: Costs and Returns-Reply
Ronald W. Chapman, MD, MPH
Department of Family Practice University of California Davis
Trevor W. Hacker, MD
Shasta Cascade Family Practice Residency Redding, Calif
Arch Fam Med. 1996;5(6):326.
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In reply
We greatly appreciated the response to our article. Stevens et al should be commended for their thoughtful insights regarding the assessment of pediatric immunization rates. Their insights are based on a large study, the results of which we look forward to seeing published.
It is true that many barriers exist in calculating a clinic's own pediatric immunization rate. One barrier that was not discussed is physician education. Physicians have been trained in a clinical modality that focuses on the individual patient sitting across the examination room. This perspective makes it very difficult for the physician to see "the big picture."
The calculation of our clinic's immunization rate is an example of community-oriented primary care in practice. Community-oriented primary care allows physicians to see the whole of their practice in a larger community context.1 Such a perspective is important in a managed care environment such as that described by Stevens
. . . [Full Text PDF of this Article]
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