Powerful trends that have influenced pediatric care in recent decades
will sweep us into the new century. By looking at the major forces at
work today, we can predict where we will be 10 years from now. As infe
ctious diseases continue to decline, psychosocial disorders will take
a larger share of the pediatrician's efforts. Technology will allow mo
re effective management, but it will require strong commitment to ongo
ing education. More children with chronic conditions and more young ad
ults will fall under the care of pediatricians. Prevention will retain
a central role in practice. Maintaining an independent practice will
become more difficult, and a wide range of delivery schemes will emerg
e. Relationships among pediatricians and relationships with other heal
th care providers will be influenced significantly by these systems, w
hich carry potential for both positive and negative impact on the qual
ity of care and on the lifestyles of pediatricians. It is crucial that
pediatritake an active and committed role in shaping the evolution of
care systems, thereby making the future what it should be for childre
n.