ROLE AND RESPONSIBILITIES OF THE SCHOOL PHYSICIAN Gertrude Fox, M.D.

Vivian K. Harlin, M.D.

Gertrude Fox, M. D., Supervising Physician and Director of Health Education and Services, Pasadena Unified School District, Pasadena, California 91 101.

Vivian K. Harlin, M.D., Director, Medical Services, Seattle Public Schools, 815 4th Street, N. Seattle, Washington 98109.

Physicians long have been members of the school health team. They have been hired by school boards part-time, full-time, and in a consulting capacity. They have been placed as administrators, directors and supervisors of school health services programs. In some districts they have been hired by local health departments with dual community and school responsibility. What is the function of the school physician on the health team? What do school boards and superintendents expect?

The phys i c ian ' s respons ib i l i t i es may encompass any one, two or more of the following:

1. Administration and supervision of the health service program: policies, procedures and p e r s o n n e l i n c l u d i n g nurses , n u r s e specialists and health aides, audiologists, audiometrists, and in some school districts occupational and physical therapists.

2. Examination of children: on admission only, at specified grade levels, or those referred by teachers for observed health problems. Referral of children with health problems to appropriate medical care facilities.

3. Examination of the students, male and female, participating in competitive athletic activities.

4. Examination and evaluation of children for special classlspecial program placement.

5. Consu l ta t ion w i th hea l th educat ion curriculum personnel or teachers regarding health education.

6. Examination of employees, certificated and/or classified on initial employment and/or after specified days of absence; health counseling with employees.

7. Evaluation of requests for medication to be given at school.

8. Immunization of pupils in those states in which certain immunizations are mandatory and in which the school physician has legislative sanction to do so.

Wi th increas ing frequency the school physician is becoming involved with the "exceptional" child - the child who has a physical, visual, auditory or speech handicap; mental retardation; aphasia; serious emotional problems; or inability to learn. Although a medical evaluation is always desirable, many of these children may be placed in special classes without one. The child who is unable to read or who cannot learn presents a special and difficult problem for the school physician. Although he cannot solve this child's difficulty, he can contribute the following to aid school personnel:

1.

2.

3.

4.

5.

6.

7.

Information about normal growth and developmental stages of childhood. A physical examination with a neurological evaluation to include: large and small muscle coordination, balance, cutaneous and deep reflexes, speech and verbalization, visual perception, directionality, memory, attention span and handedness. Suggestions and professional reassurances about investigative procedures which might aid in the evaluation. Interpretation and evaluation of outside medical reports. Direct contact with the outside physician or clinic for information andlor referral for special tests. Consul ta t ion wi th teacher, pr incipal , counselor, parent, or others regarding placement with specific suggestions. Discussion of treatment, i.e., medication, p h y s i c i a l t he rapy , p h y s i c a l a i d s , psychotherapy.

8. Discussion of the relationship of social

The physician must be involved early. Ideally, he should be asked to evaluate, with the teacher in attendance, all kindergarten pupils for school readiness, a procedure which would help to

situations to the child's problem.

THE JOURNAL OF SCHOOL HEALTH 369

insure school success by detecting present and admin is t ra to r , c l i n i c ian , and teacher. H i s potential problems. k n o w l e d g e a n d s k i l l o f fe r a s i g n i f i c a n t

contr ibut ion to the heafth and welfare of students play in the school setting. H e is advisor, and staff and to the instruct ional program.

Thus, the physician has an important role to

A TOGETHER PERSON

Two eyes. Two hands. Ears. A heart. No distinquishable characteristics. No outstanding differences. A few have become famous. But, far more remain unknown to most, though their contributions are immeasurable to those surrounding.

Two eyes that see the world. Two eyes that appear to be just like any other eyes, yet see a little bit farther and look into the eyes of others. Eyes that see heartbeats and desires. They see the“stuff” that make a man what he really is- pain, agony, life, death, meaning.

Two hands always extended. One reaching inward to the meaning of his exis- tence; the other, reaching out to people, searching for the satisfaction of companionship in union with others, seeking out the needs of individuals, seeking out pleas for understanding which have been heard by two ears.

Two ears that hear the cries of men. They listen for the subtle hints of danger. They listen to a man and hear what he cannot express in words. Ears that take the sounds of change, transposing them into impulses that are felt.

Feelings. A sensitivity to the merry-go-round of problems. That certain something that says “ I care.” I care about you because you are a worthwhile human being. And as that human being, you are important.

These are the trademarks of a “together” person. And yet, the description is incomplete.

The “together” person is tall. He stands above pettiness, but is able to bend to the level of human anxiety. He is sought out by all races because he recognizes only one color for problems. His language is universal, as he answers a universal phenomenon. He is a builder - an instiller of self-respect and self-value.

He is on a continual “high.” A high that comes naturally from love of people. And because of this, he is loved.

He may never get any farther than a Harlem street corner, or a hidden office desk. He may never become rich because his wealth cannot be counted in dollars and cents.

His debt is continuous. And he pays generously. He possesses the meaning of life and shares its connotations with others.

Thus, even i f he dies early, he leaves behind a treasure. Yet, sometimes, he cannot be aware that his concern helped to hold some person together.

-Submitted to Michael Haro by Geraldine Morris, a college

senior in a basic health course, 1971.

370 SEPTEMBER 1974 VOLUME XLlV NO. 7