Committee Histories

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Committee Histories

    Committee on Substance Abuse

    The Academy first dealt with issues of substance abuse in the Committee on Adolescence and its predecessors. Indeed, the first predecessor of the Committee was the Committee on Juvenile Delinquency (see Committee on Adolescence for the history of the Committee and its predecessors). When ACBOM met on September 26, 1983, Ann Lion, Director of the Division of Public Education, suggested that the Academy address the problem of substance abuse, using a program along the model of the First Ride program. ACBOM discussed the subject of substance abuse, but then decided to wait until the Committee on Adolescence reported. However, it did recommend that all Standing Boards meet during the December meetings to discuss substance abuse and how the Academy will pursue this program. The Board concurred and the Standing Boards discussed the issue at their December meetings. When ACBOC met, Ms Lion presented her Division proposed AAP Substance Abuse program. ACBOC approved the goals and objectives. It felt that outside funding would be needed with a time-frame such as three years. The Committee and Section on Adolescence should be involved. The Council on Child and Adolescent Health took up the matter in January, 1984. It agreed that the Academy should pursue the matter, but disagreed with the program suggested, arguing in favor of a multidisciplinary approach. There was some sentiment in favor of a Task Force on the subject. ACBOC discussed their comments at its meeting on March 6, 1984 and recommended that the Academy appoint a Task Force. The Board concurred at its meeting later that month. The first Task Force on Substance Abuse lasted a few months and was sunset after it made its report with recommendations on education. However, in the fall, the Executive Committee voted to reactivate the Committee following recommendations by ACBOC. A new Task Force was soon established. The new Task Force on Substance Abuse addressed methods of combating substance abuse, noting that “Just Say No” Campaigns were ineffective. With the Task Force due to be sunset in June, 1987, ACBOC recommended that a provisional committee be established. The Board concurred and the Provisional Committee on Substance Abuse was established effective June, 1987. In 1990, it became a regular standing Committee on Substance Abuse.

    Committee on State Government Affairs

    The Committee on State Government Affairs has a number of antecedents established for various purposes. An early Committee was the Committee on Relation of the American Academy of Pediatrics to Philanthropic, Welfare & Health & Similar Agencies. It is unclear just when the Committee was established and it is not mentioned in the minutes from Board meetings held in 1930 or 1931, but it reported at the annual meeting in 1931. In 1931, it changed its name to Committee on Relation of the Academy to Philanthropic Agencies, Welfare Workers, etc. In 1932, it changed its name again to the Committee on Relation of Academy to Public Health Agencies, Philanthropic Agencies, Welfare Workers, etc. In 1934, it became the Committee on Child Health Relations. In 1941, it became the Committee on Governmental and Medical Agencies. In the course of its life, the Committee sought to serve in an advisory capacity to state departments of health and other state and private agencies. It did not deal with legislation, but with state agencies. In its early years, the Committee worked with similar committees at the state level and with state agencies in implementing Sections of the Social Security Act. The Committee on Governmental and Medical Agencies was abolished in 1948 after its report was read to the Executive Board, apparently due to dissatisfaction with its Chairman, who proposed much, but did not follow through to the satisfaction of the Board.

    Although the Academy had a Legislative Committee from 1935 to 1958 (see Committee on Government Affairs), it did not address state legislative issues, which appears to be one reason for its demise in 1958. In 1963, however, the Executive Board voted to establish a Council on Pediatric Practice. In October, 1966, the Council established a Subcommittee on Legislation. The Subcommittee focused on state as well as federal legislation affecting children. In 1969, it became a regular Committee on Legislation. Also in that year, the Committee developed plans for creation of a Washington office for the Academy. Their efforts eventually bore fruit when the Academy opened an office in Washington in July, 1970. Ironically, the opening of that office soon raised questions as to whether the Committee was needed. The Committee also experienced difficulties with other Committees that engaged in parallel and duplicative activities and did not communicate with the Committee. Discouraged by these activities, the Committee suggested in its annual report in June, 1973, that perhaps the Washington Office could take on many of its responsibilities and that the Committee could be discontinued. The Executive Board agreed and the Committee was sunset soon afterward.

    In April, 1974, The Board appointed its Board liaison to the Committee, Dr William Howard, to serve as a liaison with the Washington Office to review and advise on current legislation. Board member Dr Thomas C. Cock submitted a proposal for a Legislative Council. The proposal went to ACBOC for review. ACBOC discussed this, and reported back with a suggestion that the Board establish an ad hoc committee to define the relationship between the Washington Office, the Executive Board and the Executive Committee. The Board discussed this at the June, 1974 Board meeting and then assigned the issue to a Board Committee on Relation of Executive Committee and Executive Board. This Committee, noting the importance of Academy involvement in legislation affecting child health at the federal and state level, discussed various alternatives including Dr Cock’s proposal for a Legislative Council. The Committee and the Board itself was concerned that the proposed council or committee would not compete with the Washington Office. In April, 1975, the ad hoc Committee reported back with a proposal that the Board appoint a committee composed of Alternate District Chairmen to consider national legislative issues. The Committee would be staffed by the Washington Office and would have consultants from other committees, councils, sections as well as AAP staff. The Board agreed to this. Accordingly, a Legislative Issues Committee composed of Alternate District Chairmen was established and commenced operations in the fall of 1975. The Committee was interested in legislation at the federal and state level. It also interested itself in state compliance with federal legislation such as Medicaid. In June, 1980, the Board approved a restructuring of Academy Departments and also approved the establishment of an ad hoc Committee on Legislation. At the same meeting, the Board tabled a proposal from the Legislative Issues Committee calling for establishment of a Political Action Committee. The Legislative Issues Committee was soon sunset and on September 18, 1980, the Executive Committee appointed an ad hoc Government Affairs Committee to work with the Washington Office.

    In 1984, the Academy established a Council on Government Affairs, but its concern lay with federal legislation and it worked closely with the Washington Office. Meanwhile, the Academy headquarters established a Department of Health Care and Pediatric Practice in 1981. In 1983, the Pediatric Practice Division was split off to become part of a new Department of Child Health Care Finance and Organization, later shortened to Child Health Care Finance. This Department became interested in state legislation and in 1986, hired Judy Cohen, now Judy Dolins, to deal with state legislative affairs. She was joined by Jim Pawelski in 1988. In 1988, ACBOPP decided to push for establishment of a Provisional Committee on State Legislation. The Executive Board agreed to this in 1989, and the Provisional Committee was established in June, 1989. The Provisional Committee concerned itself with state legislation and regulatory issues affecting the health of children. In 1992, it became a regular Committee on State Government Affairs.

    Committee on Sports Medicine & Fitness

    Sports medicine was first addressed by the Committee on Cooperation with Non-Medical Groups. This Committee was established at the Board Meeting on December 1, 1934. It met with various non-medical groups, one of which was the American Camping Association. Meetings with the latter organization eventually led to establishment of a Committee on Medical Supervision of Camps at the Executive Board Meeting of November, 1938. The Committee dealt more with medical facilities at camps than with physical fitness issues. There was no central bureau devoted to developing standards for summer camps. State statutes followed no common rule in regulating health conditions at summer camps. Minimum health standards were published and distributed by State Chairmen. In practice, these standards turned out not be universally practicable. The Committee was sunset in 1944 and its functions reverted to the Committee on Cooperation with Non-Medical Groups.

    The following year, a health card for camp examinations was prepared and distributed at a nominal cost by Mead Johnson and Company. Within a few months, more than a hundred thousand of these cards had been ordered. The Committee continued these activities, working not only with the American Camping Association, but also with the Boy Scouts and Girl Scouts and other groups who operated camps. In 1953, the Committee activities were winding down, but the Chair, asked for and got another year to complete the work of the Committee. The Committee was sunset after the October, 1954 meeting of the Executive Board, but its work continued through liaisons with other organizations.

    There was no special committee devoted to sports, physical fitness or related issues throughout the rest of the fifties and well into the sixties. However, the Committee on Accident Prevention and the Committee on School Health dealt to some extent with physical fitness and sports. In the late sixties, they developed a joint statement, “Competitive Athletics for Children of Elementary School Age,” in cooperation with an AMA Committee on the Medical Aspects of Sports, the American Alliance for Health, Physical Education and Recreation, and the Society of State Directors of Health, Physical Education and Recreation. It was published in PEDIATRICS in October, 1968. Following development of the joint statement, the Committee on Accident Prevention suggested that a group be established within the Academy that would be concerned with physical fitness, sports medicine and recreation as they relate to children and youth. The Committee discussed establishing a new committee, but finally decided that a council composed of representatives of other committees seemed the best approach. In October, 1968, the Executive Board established a Council on Physical Fitness, Recreation, and Sports Medicine composed of representatives of the Committees on Youth, School Health, Disaster & Emergency Medical Care, and Accident Prevention. In June, 1969, the Board added a member from the Committee on Children with Handicaps. In October, 1969, the Board changed the name to Joint Committee on Physical Fitness, Recreation and Sports Medicine. The Joint Committee established liaison relations with a number of organizations devoted to physical fitness, sports and recreation.

    In March, 1974, ACBOC recommended that the Joint Committee be disbanded and replaced by a committee on sports medicine. The Board concurred in April, 1974 and a Committee on the Pediatric Aspects of Physical Fitness, Recreation and Sports was established. It soon started publishing statements on sports for girls, swimming instructions for infants, minibikes, camping and the like. In 1981, it was renamed the Committee on Sports Medicine. In 1990, it became the Committee on Sports Medicine and Fitness.

    Committee on Residency Scholarships

    The Committee on Residency Scholarships has long antecedents in the old Committee on Medical Education and related Committees. The Committee on Medical Educationwas established at the meeting of the Executive Board on July 25, 1930. The Committee was concerned with into three areas of training in pediatrics: undergraduate training, postgraduate instruction, and the training of the pediatrician. The Committee worked with the Publications Committee (1930-1932) in establishing The Journal of Pediatrics as the Academy journal. In 1933, the Committee recommended that a national certification board be established to certify pediatricians. This recommendation bore fruit in the establishment of the American Board of Pediatrics that year. The Committee was very concerned over the uneven level of pediatric training in medical schools across the country. In 1936, the Committee divided itself into three subcommittees: Undergraduate, Graduate, and Post-Graduate Education in Pediatrics. The Post-Graduate division was especially active in studying the quality of training in residencies and internships at hospitals across the country. In 1941, the Committee was reduced in size with the elimination of the Graduate Division. In 1947, all divisions were eliminated and the Committee became a single Committee again. In 1958, the Committee established a Subcommittee on Post-Graduate Medical Education. In 1982, the Committee was merged with the Committee on Scientific Program to form the Committee on Scientific Meetings.

    At its meeting on November 8, 1944, the Executive Board also established a Committee on Post-war Courses in Pediatrics for pediatricians returning from service in the Armed Forces. It surveyed interest in refresher courses in pediatrics and assisted physicians in securing residencies at hospitals around the country. Presumably, medical schools offered refresher courses as the Academy did not. Academy Secretary-Treasurer Dr. Clifford Grulee administered the program out of the Academy office in Evanston. The Committee ended in 1948, but the Academy continued to administer the program out of the Secretary’s office in Evanston until it was sunset in 1953.

    The Committee on Improvement of Child Health and its predecessors (see Committee on Community Health Services) also dealt with the education of pediatricians since they felt that it did no good to provide pediatric care to children if the pediatricians did not receive good training. After the Committee was sunset, its education functions were taken over by the Committee on Medical Education.

    In 1951, Mr. D. Mead Johnson offered to give eight scholarships to pediatric residents, each scholarship to consist of $1000 a year for a period of one year for each resident. The preference was for individuals who intended to go into practice rather than research or academia. Preference was also to be extended to residents who were in smaller training centers. The proposal apparently was made to members of the Committee on Medical Eduction, which established a Subcommittee on Residency Fellowships headed by Dr. James G. Hughes to discuss the matter. Dr. Hughes reported back at the May, 1952 Executive Board meeting. He could see no reason to turn down free money. The Committee originally wanted to start the project in July, but decided to hold off since the Board had not had a chance to pass on it. The Committee also was anxious to give the project maximum publicity reaching the smaller pediatric departments lest the larger ones with their ears to the ground in search of funds would spot the fellowships before the smaller training centers in more remote areas. The Committee was committed to equal opportunity in securing fellowships. When the Committee on Medical Education met in March, 1952, to consider the plan, they also suggested that it would be good to offer the money to those who had completed their first year of residency, but did not have enough money to complete their training.

    The Board agreed to the plan and appointed the Subcommittee as a Committee on Residency Fellowships to handle the publicity for the project and decide who was to receive the fellowships. The Executive Secretary, Dr. Einor H. Christopherson would handle the administrative work and release funds to the recipients chosen by the Committee. Over time, the program was expanded as Gerber Products and McNeil Labs joined Mead Johnson in donating funds for scholarships. In 1990, the Committee was renamed the Committee on Residency Scholarships and continues under this name to this date.

    There also was a Committee on Central and South American Scholarships established by the Executive Board in December, 1939 to procure fellowships for pediatricians from Latin America, who wished to study in the United States. In 1941, it became the Committee on Pan-American Scholarships, and in 1949, its scope was enlarged and it became the Committee on Latin American Affairs. This Committee was sunset in 1957, but its concerns were later addressed in a new Committee on International Child Health established in 1962 (see Committee on International Child Health for the history and chairmen of these Committees).

    Committee on Quality Improvement

    In October, 1963, the Executive Board decided to establish a Council on Pediatric Practice based on a recommendation of a Committee it appointed to study the issue. The purpose of the Council was to establish standards for child health care. It apparently was decided that the new Council would handle issues addressed by the Committee on Medical Care as it apparently was sunset in 1963. The Council does not appear in the 1964 Fellowship Directory, but apparently started operating that year. The Council soon decided to focus on the insurance needs of children and the development of standards of pediatric practice for use as guidelines in several areas. In March, 1965, the Council decided to rewrite and redefine the “Standards of Practice” and subject them to review by a number of colleagues of members of the Council in order to produce as representative and practical a set of plans and specifications of desirable pediatric procedures as possible. Accordingly, it set up a Subcommittee on Standards of Child Health Care headed by Dr. Hugh Thompson to research the problem. In 1967, the Academy published the first edition of Standards of Child Health Care. It eventually went through three editions, the last of which was published in 1977. The Subcommittee became a full Committee on Standards of Child Health Care in 1969. The Committee usually concerned itself with quality assurance issues, but sometimes developed positions on issues that related to practice management.

    Pediatric practice issues soon became an important concern of the Academy, especially in the seventies. Although the Committee dealt with such issues to some extent, the Academy ultimately established another committee to deal with practice management. This Committee ultimately became the Committee on Practice and Ambulatory Medicine (COPAM). The Committee on Child Health Standards lingered on into 1979. At the April, 1979 meeting, the head of the Committee met with the Board to consider future plans for his Committee, but no action was taken. Instead, it was shortly phased out.

    Meanwhile, the Council on Pediatric Practice continued its deliberations. In 1989, issues of quality assurance arose again. The Council devoted two meetings to such issues and finally recommended that a Task Force on Quality Assurance be established to address the problem. The Executive Board agreed to this at its meeting in October, 1989. The Task Force was appointed and it met for the first time in October, 1990. In 1992, the Task Force became the Provisional Committee on Quality Improvement and in 1995, it became a full standing Committee on Quality Improvement.

    Committee on Public Education

    The Academy engaged in some health education efforts even in the late thirties and early forties through films produced by its Committees. One of the most famous was “When Bobby Goes to School,” which was so extensively used that by 1946, it was worn out. The Committee on Mental Health also produced a film, “The Problem Child.” However, there was no committee devoted exclusively to public education until the fifties.

    When the Executive Board met in September and October, 1954, there was some discussion on the possibility of establishing a committee to promote child health education. The proposal was referred to Dr. George Wheatley who studied the issue at some length and reported back, first in March, 1955 and then in September, 1955. Dr. Wheatley surveyed members on the issue and found a great deal of support for such a committee. In his report, Dr. Wheatley suggested that a Committee on Health Information could aid the individual practitioner to increase his health educational skill with families, enhance pediatric public relations, and promote research in educational techniques to improve imparting of health knowledge to parents and children. Implicit in the entire project was the concept that the pediatrician is a teacher of parents and children. The committee was also to be a source of information for radio and television programs on health education. After presenting his report, Dr. Wheatley moved that a Committee on Health Information be established. The motion carried. However, the Committee was short-lived. The Committee made some proposals for a program of public education. However, the Executive Board discussed the issue at its meeting in March, 1957 and concluded that other Academy committees also did public education and that it would be difficult for the Committee to proceed without infringing on the activities of other committees. Therefore, the Committee was dissolved.

    The Academy continued to conduct health education through its publications. In the sixties, the Academy’s health education activities and public relations activities expanded. In 1965, John P. Lynch joined the Academy staff as administrative assistant for health education and information, replacing Pat Scherf, who left the Academy for matrimony. Within a short time, Mr. Lynch was in charge of a Department of Public Relations and Information.

    In 1968, Dr. Leo Bell urged that the Academy fund production of a public service film to demonstrate what constitutes health workers. The Council on Pediatric Practice discussed health education and decided that the Academy should reconsider its responsibility for health education of the public as one of its functions. In view of this, the Council recommended in October, 1968, that the Executive Board reexamine its total health education efforts and consider the film proposal within that context. The Board responded by appointing an Ad Hoc Committee on Health Education of the Public. This Committee worked with John Lynch of the Department of Information and eventually reported in April and October, 1969. They found that other organizations were involved in public health education and they encouraged the Academy to do more of it.

    In October, the Ad Hoc Committee recommended appointment of a standing Committee on Public Information to work with the Department of Information on a program of public health education. The Board agreed at its October meeting, and established the committee. At its next meeting in April, 1970, the Board approved the appointments of committee members. The Committee soon set to work. It worked with Action for Children’s Television in presenting a National Symposium on Children and Television at the 1971 annual meeting. It also worked with other organizations on films, video-cassette programs, television public service announcements, and publications to advise the public about immunization and other issues. It worked closely with the Department of Information, later the Department of Communications and Membership and acted primarily as an advisory committee to that department. Members of the Committee such as Dr. T. Berry Brazelton often acted as liaisons to other organizations, thus aiding the work of the Committee.

    In January, 1976, the Executive Board discussed the Committee and the Communications Department and appointed an Ad Hoc Committee on Department of Communications to investigate both. It reported back in April, June and October, noting the progress that had been made by both entities. In October, 1976, it recommended that the Committee on Public Information become the Committee on Communications and Public Information with a revised charge. The Board concurred and the change was made. The revised Committee developed public information programs and identified areas of child health in which the need for public education was greatest. The Committee worked with other AAP committees to assist them in developing public education materials related to their special areas of interest. The Committee was responsible for technical and ethical standards of Academy health education materials. It also worked to obtain financial support for such publications from government, foundations and industry. It continued to develop public service television announcements. It also assisted in the formation of pediatric advisory boards for major magazines such as Family Circle. The Committee was a member of the Council on Child Health, later Council on Child and Adolescent Health.

    In 1980, ACBOM was given additional responsibility, including oversight over Academy communications and public relations. In view of this, ACBOC recommended in May, 1981 that the Committee on Communications and Public Information be discontinued as part of an economy drive. The Board concurred in June, 1981. Meanwhile, ACBOM met in May, 1980 and suggested that it be directed to investigate means of promoting pediatrics as a profession. The Board agreed to this at the June, 1981 meeting. At the October meeting, the Board approved a further ACBOM recommendation that it set up a Task Force on Promotion of Pediatrics. The Task Force commenced operations early in 1982. Following the 1982 annual meeting, the Task Force kicked off a new program called “A New Age in Pediatrics.” In 1983, the Task Force became the Task Force on the New Age in Pediatrics. The Task Force engaged a public relations firm to assist in its activities. The Task Force addressed a variety of issues including promotion of pediatrics and pediatricians as well as public education on child health issues such as substance abuse. Through its various efforts, the Task Force gained an appreciation of the value of communications and recommended that the Academy continue extensive public relations activity. In 1985, the Task Force became the Provisional Committee on Communications.

    Meanwhile, early in 1983, the Council on Child and Adolescent Health recommended that an ad hoc Task Force on Children and Television be established to carry out AAP activities on the issue of children and television. ACBOC agreed at its meeting in March, 1983 and the Executive Board concurred in April, 1983. The Task Force studied the effects of television on children and suggested means of improving the educational content of television. The Task Force worked with outside organizations such as Action for Children’s Television. When the Provisional Committee on Communications was established, the Task Force on Children and Television worked in cooperation with the Committee. It was sunset in June, 1986. Its functions appear to have been taken over by the Committee on Communications. The Provisional Committee on Communicationsbecame a regular Committee on Communications in 1987. In 1999, it became the Committee on Public Education, which it remains today. The Committee is primarily concerned with the impact of media such as television, music lyrics, advertising and the like on children.
    Committee on Psychosocial Aspects of Child & Family Health

    On April 16, 1931, the Executive Board established the Committee on Mental Hygiene to study the psychiatric problems of children. The Committee addressed not only obvious mental problems, but difficulties that children faced in adjusting to changing circumstances in the family. In 1939, it became the Committee on Mental Health. In the 1940’s, the Committee, with the aid of funding by the Pet Milk Company, produced a film, “The Problem Child.” The Committee sought to improve the teaching of mental growth and development in pediatric departments. Unfortunately, most schools found it difficult to attract properly trained instructors at a salary they could afford. In the late forties, when the Academy established Sections, the Committee sought to establish a Section on Mental Growth and Development. The Board agreed to this and in 1948, the Committee became the Section Executive Committee for the Section on Mental Growth and Development.

    The new Section had difficulty finding its focus for a time. In 1954, it became the Section on Mental Health. In 1958, the Section was discontinued and a Committee on Child Development was established to address the concerns of the Section. The Committee soon resolved the problems of focus and the Section reemerged in 1960 as the Section on Child Development. In 1988, it became the Section on Developmental and Behavioral Pediatrics. During the fifties, sixties and seventies, the Section in its various formats, addressed the concerns of child development and childhood mental health.

    In January, 1979, the Legislative Issues Committee noted that the Academy had no formal policy on mental health. Soon afterward, Dr. Jean D. Lockhart, Director of the Department of Health Services and Government Affairs, wrote to Henry H. Work, MD, FAAP, Deputy Medical Director of Professional Affairs of the American Psychiatric Association noting that there was no one Academy Committee concerned with mental health. In his reply in March, 1979, Dr. Work noted that there had been a Committee on Mental Hygiene established in the thirties and that the Section on Child Development was now the one piece of the Academy most concerned about mental health. Dr. Work, a member of the Section, thought that “it may well be that, as a section, it is not an appropriate action arm.” He proposed to write to Dr. Bruce Graham about the situation and expressed the hope that a workshop could be held on prevention of mental health problems. In her report to the Board in April, 1979, Dr. Lockhart suggested several options, one of which was to form a committee or task force devoted to mental health or appoint child psychiatrists to Academy committees. The Board adopted the second suggestion and also referred the report to the Council on Child and Adolescent Health and the Section on Child Development.

    In January, 1980, the Council on Child and Adolescent Health recommended that a new committee be established on behavioral pediatrics and the family. ACBOC approved the proposal in March and the Board followed suit in April, 1980. To keep costs down, the new Academy reduced slots for other Committees and assigned them to the new Committee. The Board directed the new Provisional Committee on Behavioral Pediatrics and the Family to study and make recommendations relative to the role of the pediatrician as family-behavioral counselor knowledgeable about family dynamics; address social changes affecting families and advise the Board on the implications to pediatricians and the children for whom they care; review Academy manuals and statements for behavioral and mental health content and implications, and make recommendations for appropriate changes; review and analyze legislation in the behavioral and mental health fields and prepare (in conjunction with the Evanston and Washington offices) appropriate Academy responses and policy statements; develop liaison relationships with the other committees of the Council on Child and Adolescent Health, with related AAP Sections and with other organizations concerned with behavioral and mental health issues in children; assist the Academy’s Department of Education to develop educational content and programs in behavioral pediatrics for medical students, house staff, practicing pediatricians, and for other health professionals working for and with children; and make recommendations for the future work of this committee. The Committee soon changed its name to Provisional Committee on Psychosocial Aspects of Child and Family Health. It met for the first time in October, 1980. In 1982, the Committee became a regular standing Committee.

    Committee on Practice & Ambulatory Medicine

    In October, 1963, the Executive Board decided to establish a Council on Pediatric Practice based on a recommendation of a Committee it appointed to study the issue. The purpose of the Council was to establish standards for child health care. It does not appear in the 1964 Fellowship Directory, but apparently started operating that year. The new Council soon established a liaison relationship with the Association for Pediatric Ambulatory Services, which was concerned with the delivery of outpatient care to children. At the 1966 annual meeting, the Council, then headed by Dr. Carl C. Fischer, presented a panel on “Pediatric Practice—Increasing the Effectiveness of Office Practice.” The Council continued to hold workshop meetings at annual and spring meetings. The Council also put out a Bulletin of Pediatric Practice. However, it did not set up any subcommittee specifically devoted to pediatric practice, though in 1965, it did establish a Subcommittee on Standards of Child Health Care, later the Committee on Standards of Child Health Care. This Committee usually concerned itself with quality assurance issues, but sometimes developed positions on issues that related to practice management. Indeed, directives to the Committee charged it with responsibility for developing statements on improving record-keeping practices. In the fall of 1974, the Committee issued an Overview Statement on Medical Records. Meanwhile, the Council continued to host seminars on practice management.

    In 1975, staff of the Department of Committees proposed a task force on standardized record forms for ambulatory pediatric care. ACBOC reassigned the project to the Committee on Standards of Child Health Care. The issue was discussed at the Executive Board meeting in June, 1975. Because of the importance that the Board gave to the question and the perception that the Standards Committee might not be interested in it, President John C. MacQueen suggested writing to the Committee and indicate that this was a priority item of the Board and ask them to do it. If they did not wish to do so, they should immediately inform the Executive Committee so a Task Force could be appointed. At the same meeting, the Board directed the Committee to develop a system for record-keeping for use in ambulatory health care. The Committee responded by proposing a joint task force with the AMA. There was further discussion in the Committee and the Executive Board. In April, 1976, the Board expressed doubts about a joint task force and after further discussions, directed the Executive Committee to meet with the head of the Standards Committee on the subject. In June, the project was referred to the Academy’s Department of Health Services to develop such a system. Eventually, a Task Force was formed to work with the Department in setting up the system. The Department finally developed one by 1978 and worked with the Task Force in developing plans for marketing it.

    Meanwhile, the Council on Pediatric Practice set up an ad hoc Committee on Practice Management late in 1975. There was also a proposal by Dr. Byron Oberst to set up a Section on Pediatric Practice. However, when the proposal went out to District and Chapter officers for comment, it found very little support. Accordingly, the Board, rejected the proposal in April, 1976, and instead relied on the ad hoc Committee on Practice Management to handle such concerns. The Board approved a motion to establish the Committee as a standing Committee and defeated a motion to let it continue as an ad hoc committee of the Council on Pediatric Practice. Nevertheless, it continued as an Ad Hoc Committee for several years. The Fellowship Directory for January, 1979 shows it as a Provisional Committee on Practice Management, indicating that it became one in 1978. However, Board minutes do not reflect this. In April, 1979, the Executive Board approved ACBOC’s proposal that it become a standing committee. In June, 1979, the Board requested a name change and the Committee became the Provisional Committee on Practice and Ambulatory Medicine. Meanwhile, the head of the Committee on Standards of Child Health Care met with the Board in April, 1979 to consider future plans for his Committee, but no action was taken. Instead, it was phased out and its functions and several of its members were taken over by COPAM. In 1982, COPAM became a regular standing Committee.

    Committee on Pediatric Workforce

    The Committee on Pediatric Workforce has long antecedents that have dealt with individual concerns currently addressed by the Committee. The current Committee addresses work force issues pertinent to pediatrics including the supply and distribution of pediatricians, the demographics of the pediatrician population including the gender and racial/ethnic diversity within the pediatric workforce, pediatric graduate medical education, International Medical Graduates, and the provision of care by allied health personnel. One of the earliest Academy committees was the Committee on Pediatric Nursing Education. It probably was established in 1930 or 1931, but does not appear in any minutes prior to the first annual meeting. At that time, it reported on its activities in February,1931. The Committee studied the pediatric education of nurses. Its name was shortened to Committee on Nursing Education about 1941. It apparently was abolished in 1947 as it does not appear in Fellowship Directories after that year.

    Meanwhile, in 1941, the Academy established the Committee on Geographical Distribution of Pediatricians. This Committee surveyed the distribution of pediatricians. The Committee noted the gradual shift in distribution of pediatricians from a concentration in the East, especially the Northeast, and the West Coast to a more even distribution throughout the country. Its findings proved very useful when the Academy redistricted in the late forties and in the fifties. For the first 10 years, Dr. Otto L. Goehle was a Committee of one, but in 1950, the Committee was expanded to nine members, eight of which represented Academy Districts. The Committee was sunset in 1957.

    In October, 1963, the Executive Board decided to establish a Council on Pediatric Practice based on a recommendation of a Committee it appointed to study health insurance for children and other issues. The purpose of the Council was to establish standards for child health care. It does not appear in the 1964 Fellowship Directory, but apparently started operating that year. The Council gradually set up a number of Subcommittees, one of which was a Subcommittee on Pediatric Manpower, established in 1966. In 1969, it became a full Committee on Pediatric Manpower. The Committee dealt with workforce issues including employment of pediatric nurses and other allied health personnel as well as pediatricians. The Committee had contacts with the AMA, and pediatric nurse practitioner and other nursing organizations. It held workshops for pediatricians and nursing personnel. The Academy also established a liaison relationship with the National Medical Association to cooperate on improving access to care in minority neighborhoods. In 1968, the Committee surveyed pediatricians on their use of allied health personnel in their practice. Pediatricians noted the use of nurse practitioners. In 1969, on the recommendation of the Committee, the Academy established an Office of Allied Health Manpower in the Department of Community Health Services. In 1970, the Committee set up a joint liaison committee with the American Nurses Association.

    By 1973-1974, the Committee’s relations with pediatric nursing organizations were strained due to differences over training and certification of pediatric nurses. In 1972(?) the Executive Board set up an ad hoc Committee on AAP Policy on Manpower headed by Dr. Bruce Graham to address the issue. The Committee on Pediatric Manpower worked closely with the ad hoc Committee in developing a position on pediatric nurse practitioners. Later, another ad hoc Committee, headed by Dr. John C. MacQueen, was appointed to negotiate with NAPNAP, which it did in 1974. An ad hoc Committee on PNP Certification made arrangements for the National Board of Medical Examiners to develop an exam for pediatric nurse practitioners. The Committee on Pediatric Manpower also appointed an ad hoc Committee on Certification to develop standards for certification of nurse practitioners. The ad hoc Committee was a joint effort with pediatric nurse practitioner organizations. The Committee also worked on developing standards for certification of medical assistants.

    In 1975, the broad range of allied health personnel in pediatric offices led ACBOC to recommend that the Committee on Pediatric Manpower be renamed and given a new directive to cope with new responsibilities. The Committee was not renamed, but it was given new responsibilities. Dr. MacQueen joined the Committee later in the year. Meanwhile, in the same year, the Board also appointed an ad hoc Committee on Mid-Career Opportunities to address expanding opportunities for pediatricians in mid-career. At the request of the Committee, it was soon renamed the Ad Hoc Committee on Expanded Pediatric Careers. It became a regular standing Committee in 1977. However, it only lasted until 1979 when it was discontinued. Its counseling functions were transferred to the Committee on Medical Education. The Ad Hoc Committee on AAP Position on Manpower completed its work in 1977 and made recommendations for a revision of the Committee on Pediatric Manpower. The Board accepted the recommendations and a new Committee was appointed in 1978. In October, 1978, at the recommendation of an Ad Hoc Committee on Relations Between the AAP and NAPNAP, the Executive Board appointed a Provisional Committee on Nursing and Other Allied Health Personnel. This Committee was discontinued in 1980, though the Board did decide to maintain a liaison relationship with nursing organizations. Its functions were transferred to the Committee on Pediatric Manpower and to the Committee on Fetus and Newborn.

    By the 1980’s, there was strong interest in the increasing role of women in pediatrics. Dr. Jean Lockhart, head of the Department of Health Services & Government Affairs (now Committees and Sections), reported that there were only 7 women out of a total of 211 committee members. An AAP membership survey suggested that about 15% of AAP members were women, but Dr. Lockhart felt that it was probably higher than that. It was felt that the poor representation of women on committees was a serious enough subject that it should be discussed further. Dr. Lockhart reported again on the subject at the June, 1981 meeting of ACBOM. ACBOM recommended that a task force or ad hoc committee be formed to address the issue. The Board agreed at its meeting in July, 1981. The Task Force on Opportunities for Women in Pediatrics published a report in 1982. In October, 1982, the Executive Board referred the report to ACBOC for action. ACBOC adopted all recommendations of the Task Force, including appointment of a Provisional Committee on Opportunities for Women in Pediatrics in 1983. In 1986, staff suggested that this Provisional Committee and the Committee on Pediatric Manpowerbe merged into one Provisional Committee on Careers and Opportunities. ACBOPP agreed but was concerned that this would give the impression that the Academy was reneging on a promise made to the Task Force. At the suggestion of Dr. Lockhart, the new Provisonal Committee was given the same mission as the previous two committees with possible additional duties as appropriate. ACBOPP also took care to select a woman of stature to head the new Provisional Committee. Accordingly, they selected Dr. Antoinette Eaton as chair.

    The new Provisional Committee became a full Committee on Careers and Opportunities in 1989. The new Committee established a Subcommittee on Women in Pediatrics at its meeting in October, 1992. In 1996, ACBOPP recommended that the Committee be renamed Committee on Pediatric Workforce to recognize the increasing scope of issues that came within its purview. The Board agreed to this at its meeting in February, 1996.
    Committee on Pediatric Research

    Dr. Marshall Carleton Pease points out in his history of the Academy that research in the field of pediatrics was close to the hearts of the founders. They wanted the Society to support pediatric research and so specified in the Constitution. The earliest Academy committee devoted to pediatric research was the Committee on Clinical Investigation & Research. It was established at the Executive Board meeting of June 13, 1931. Its purpose was unclear at first. Indeed, Dr. Grulee, who served on the Committee, remarked at the November, 1931 Board meeting that he was unsure just what the Committee was supposed to do. Dr. C. Anderson Aldrich noted that they had hoped that the Committee would back some research work. In any event, the Committee made no reports for the first few years.

    However, in June, 1935, it reported that manufacturers of foods and pharmaceuticals were making grants for research in the hope of commercial gain. The Committee felt it desirable that manufacturers make contributions for pediatric research, and felt that the Academy or the National Research Council could obtain funds from manufacturers for research and then dispense them to competent investigators who would then be under no moral obligation except to the Academy itself. The Committee recommended that the Academy develop a plan for doing this. The Executive Board responded by establishing the Committee on Allocation of Research Funds. However, at the meeting of November 35, 1935, the Board decided to reconstitute it as the Council on Pediatric Research.

    The Committee on Clinical Investigation and Research, meanwhile, continued to function. In 1936, it studied a proposal by the Borden Company to allocate patent rights to the Academy to freeze breast milk. The Committee noted that this would require establishment of a committee to visit and investigate all users of the patent, oversight of all uses of the patent to see that proper procedures were followed in freezing the milk, and litigation to protect the patents. The Committee concluded that this would be very expensive and thus not something that the Academy should get into. The Committee also considered an offer by Mead Johnson to subsidize awards for pediatric research. The Committee felt that the offer should be accepted, but that awards did not fall within its purview. It recommended that the Academy establish another committee to administer the program. The Academy did so in 1939. The Committee on Clinical Investigation and Research sometimes received offers of funds for research. It referred them to the Council on Pediatric Research. In 1940, it was discontinued and its functions merged with the Council on Pediatric Research.

    The Council, meanwhile, had its own problems. The Academy set it up as a semi-independent organization and as a result had little immediate or direct control over the Council’s policies or actions. Soon after it was established, the Council set to work developing plans for allocating funds for research. In 1936, it set up offices in Detroit with a grant of $20,000 from the Carnegie Foundation and under the direction of Dr. Thomas B. Cooley. Other companies also made donations. However, most donors wanted to fund projects that would prove commercially successful. They usually specified who was to receive the grant to conduct the research, though they assured the Council that the researchers were competent. The Council’s report for November, 1939, reported that “a greater proportion of the firms than we had realized who profess an interest in subsidizing “research” do not really care anything for the scientific value of the investigation, so long as the published article gives them something which they can play up in their advertising.” The Academy finally stopped supporting it. In October, 1941, Academy Secretary Dr. Clifford Grulee announced that the Council had been reorganized and in the future would act largely in an advisory capacity. The last few years of its existence were given over to the process of dying and liquidation of its affairs. It made no reports during this time. It finally disappeared from the Fellowship Directory in 1945. Dr. Pease noted that this was the only failure of the Academy (up to 1951).

    In the early 60’s, the Academy participated with the American Pediatric Society, the American Board of Pediatrics, the Society for Pediatric Research, and the AMA Section of Pediatrics in a Joint Committee on Pediatric Research, Education and Practice. Dr. Robert E. Cooke of the Society for Pediatric Research, chaired the joint committee. The Executive Board appointed Dr. Harry A. Towsley as the Academy representative to the Committee in 1961. In 1964, the Committee conducted a survey of pediatricians on their practice concerns. Nothing much seems to have come of this and the Committee eventually disappeared from the Fellowship Directory after 1969. Throughout the period, Dr. Cooke chaired the Joint Committee while Dr. Towsley and sometimes others as well represented the Academy.

    In the spring of 1974, the Department of Committees, headed by Dr. Jean Lockhart, proposed that the Academy set up a Task Force on Human Experimentation/Medical Ethics/Informed Consent. The staff report noted negative attitudes toward experiments involving human subjects and cited the Tuskegee syphilis study and the San Antonio placebo birth control study. The report also noted attacks on pediatric research, and cited Dr. Saul Krugman’s Willowbrook hepatitis studies, Dr. Joan Hodgman’s “gray syndrome” chloramphenicol research in Los Angeles, and skim milk studies in Texas. The staff report urged that the proposed Task Force: a.) serve as a clearing house for matters pertaining to experimentation and informed consent; b.) mobilize Academy activities in this area, in response to governmental or medicolegal demands; c.) provide advice to members; d.) formulate policy for the consideration of the Executive Board; and e.) to publicize, especially to lay groups, the benefits of research. The Executive Board felt that there were two issues involved, human experimentation and informed consent, but felt that they could be handled by one task force. Accordingly, after some discussion at the June Board meeting, they established a Task Force on Pediatric Research, Informed Consent and Medical Ethics.

    The Task Force commenced operations soon afterward. In August, 1975, the Committee published in PEDIATRICS the “AAP Code of Ethics for the Use of Fetuses and Fetal Material in Research.” In June, 1976, the Task Force became a regular Committee on Pediatric Research, Informed Consent and Medical Ethics with a new directive: a.) to advise the Board on issues of ethical considerations of research, informed consent in research and in pediatric practice, and ethical questions affecting pediatricians, and b.) to provide consultation to the Academy as requested on legislative, regulatory or other developments in pediatric research, informed consent and medical ethics. At the same meeting, the Executive Board also discussed a proposal for a committee to support pediatric research.

    In April, 1977, ACBOC proposed to increase the Committee’s size, but deferred action to the June meeting. At that meeting, they voted instead to terminate the Committee and set up a new Committee to commence operations that fiscal year. In November, the Executive Board approved ACBOC’s proposal for a Provisional Committee on Research. In 1979, it became a regular Committee on Research. The Committee was asked to make recommendations concerning Academy positions regarding research in children; to seek the support of the practicing and the research arm of the Academy for pediatric research, and to act in concert with other pediatric research bodies.

    In 1984, the Executive Committee held a retreat, during the course of which they discussed expanding the number of Academy Councils. On August 20, 1984, Executive Director Dr. M. Harry Jennison sent a memo to the Executive Committee and the Executive Board in which he proposed a new Council on Pediatric Research. On September 27, the Executive Committee approved the concept and directed that the Committee on Research become the new Council on Pediatric Research. The Council on Pediatric Research maintained a liaison relationship with other organizations interested in research affecting children and made specific recommendations for research funding by government and other organizations. It also provided peer review for research activities in the Academy’s own Department of Research. In 1999, the Academy restructured some Committees and Councils. As a result, the Council on Pediatric Research became the Committee on Pediatric Research.

    Committee on Pediatric Emergency Medicine

    The Committee on Pediatric Emergency Medicine shares similar roots with the Committee on Environmental Hazards, but they evolved in different directions. In October, 1953, the Executive Board read a letter from Dr. Norman C. Kiefer, Federal Civil Defense Administrator, regarding the possibility of the Academy preparing a manual to cover the care of children during an emergency. Dr. Stewart H. Clifford moved that Dr. Francis McDonald be appointed a committee of one to explore this problem of special care of children in an emergency and report back to the Board. The Board concurred and Dr. McDonald was appointed to head a one-man Committee on Civil Defense. The Executive Board also established a Committee on Cooperation with the Armed Forces in 1953, but sunset it in March, 1957. In its last year or two, it was given no work to do. Dr. McDonald reported back in October, 1954 with a recommendation that a permanent committee on disaster be established. He also made recommendations for the care and treatment of children in disasters. The recommendations were referred to the appropriate committees. In the fall of 1955, the Board voted to expand the Committee’s size and scope and renamed it the Committee on Civil Defense and Disaster. However, the Committee did not meet. Executive Secretary Dr. Einor H. Christopherson noted this in his report to the Board in April, 1956 and also noted that he had received no report, though Dr. McDonald phoned him with reports of his own contacts with civil defense officials in Washington. Dr. Edgar Martmer suggested that the Committee be disbanded and that Dr. McDonald be appointed as a liaison representative to the National Civil Defense and let him find out what pediatricians were expected to do in a war emergency. The Board agreed and voted to disband the Committee and appoint Dr. McDonald as a special liaison to the National Civil Defense.

    Dr. McDonald reported back in August, 1957 with concrete recommendations for informing pediatricians of the importance of civil defense measures and the dangers of radio-active fallout. He also noted the need for preparation for defense against natural disasters such as tornadoes. Dr. McDonald was serving in the Navy at that time. Meanwhile, at the Executive Board meeting on June 8, 1957, Dr. Christopherson read a letter from Dr. Robert A. Aldrich in which he expressed concern about plans for disaster control as it affected children. Dr. Christopherson noted that he had written back to Dr. Aldrich about the Academy’s contacts with the National Research Council and the Atomic Energy Commission. Dr. Christopherson thought that the Academy could work with the AMA on the issue and refer all Academy material to Dr. Aldrich. The next day, Dr. Christopherson noted a second letter from Dr. Aldrich on the dangers of radiation and fallout. Dr. Clifford also reported a phone call from Dr. Lee Farr, the Academy representativ to the National Research Council expressing similar concerns. Dr. Farr suggested that the Academy establish a committee on radiation effects in childhood. After some discussion, the Board voted to establish the Committee on Radiation Hazards and Epidemiology of Malformations.

    This Committee eventually became the Committee on Environmental Hazards and later the Committee on Environmental Health (see Committee on Environmental Health). While the Committee was originally formed to address the effects of nuclear war and other disasters, it evolved into a Committee concerned with a wide variety of environmental problems.

    Early in 1967, Secretary of Chapters Dr. James B. Gillespie attended an AMA Regional Conference on Disaster Medical Care. The purpose of the conference was to promote the development of state and local programs of medical preparedness for disaster. Board minutes are silent on the issue. However, it appears that some time in 1967, a Committee on Disaster & Emergency Medical Care was established. It met for the first time on October 23, 1967. The meeting resulting in adoption of several objectives: to make recommendations to the overall programs for the injured and sick in disaster and emergency medical care; and to inform Academy members and other pediatricians concerning the problems of disaster and emergency medical care in the pediatric age group. They also considered preparation of a small concise manual on standards for pediatric emergency medical service in hospitals. However, at their next meeting in Evanston on June 6, 1968, they decided that this would merely duplicate those manuals that were already available. Instead, they decided to prepare a chapter on pediatric emergency care and recommend its addition to either an AMA booklet on emergency medicine or a similar manual by the American Society of Anesthesiologists. Within a year, however, they changed their mind and decided to produce a manual on pediatric emergency care. Disaster and Emergency Medical Services for Infants and Children was finally published in 1972.

    The Committee chair was also the pediatric representative to the AMA Commission on Emergency Medical Services. Since some of its interests overlapped those of other Academy Committees, notably Accident Prevention and School Health, the Committee adopted a subordinate role in those areas and simply assisted the efforts of the appropriate committee. The Committee established a liaison with the Committee on Accident Prevention. It also had a liaison relationship with the American College of Emergency Physicians. The Committee did not meet for a few years or so in the early 70’s pending completion of the manual, but then commenced meeting again in 1972. On Mar 15, 1975, ACBOC decided to sunset the Committee on Disaster and Emergency Medical Care and delegate its functions to the Committee on Accident Prevention. The Board agreed to this in June, 1975, and the Committee was sunset. At the same meeting, they also voted to defer publication of a revision of the disaster manual. In the end, it was not published.

    Meanwhile, the Committee on Hospital Care established a liaison relationship with the Committee on Disaster and Emergency Medical Care. When the latter disbanded, ACBOC proposed that its functions go to the Committee on Accident Prevention. Instead, they went to the Committee on Hospital Care. At its meeting in March, 1976, the Committee set up a Subcommittee on Emergency Medical Services. In 1978, it became the Subcommittee on Ambulatory and Emergency Care. In 1981, it became the Subcommittee on Emergency Medicine. It is unclear whether the Subcommittee lasted much longer as it is not listed as a subcommittee after 1981, though the Committee continued to interest itself in pediatric emergency medicine. The Committee on Hospital Care also established a relationship with the American College of Emergency Physicians (see Committee on Hospital Care for Committee chairs).

    Over the years, the Academy experienced a rapid growth in the number of Sections. By 1979, pediatricians involved in emergency medical care wanted a Section of their own. They organized an ad hoc Committee on Pediatric Emergency Care, which in turn proposed establishment of Section on Pediatric Emergency Medicine. The proposal went to ACBOE in March, 1980, but action was deferred pending background information. After consideration by ACBOE and the Council on Sections, the Executive Board finally approved establishment of the Section on Pediatric Emergency Medicine at its meeting in January, 1981.

    The new Section soon established a liaison with the Committee on Hospital Care and with the American College of Emergency Physicians. Section members were very concerned about pediatric care in hospital emergency rooms. To address their concerns, they proposed a Task Force on Pediatric Emergency Medicine. The Committee on Hospital Care approved the concept at its meeting in April, 1983. Soon afterward, ACBOC recommended that the proposal be tabled until ACBOC could meet again in September. Board minutes do not reflect just when the proposal was approved. However, the Executive Committee did indicate discontent with policies by the American College of Emergency Physicians and the American Heart Association regarding pediatric emergency care in their report to the Executive Board in January, 1984. In any case, a joint AAP/ACEP Task Force on Pediatric Emergency Medicine commenced operations to a limited extent by the end of 1983 and met for the first time(?) in February, 1984.

    The Task Force worked with the Section on Pediatric Emergency Medicine on the APLS course in emergency medicine and other projects. The Task Force soon determined that a regular Academy Committee on Pediatric Emergency Medicine was needed. The Executive Board approved the proposal at its meeting in January, 1985. In July, 1985, the Task Force was replaced by a Provisional Committee on Pediatric Emergency Medicine. In 1988, it became a full Committee on Pediatric Emergency Medicine.

    Committee on Pediatric Education

    The Academy has long been interested in the education of its members. One of the first Committees established was the Committee on Medical Education (see Committee on Continuing Medical Education for its history). In 1973, ACBOC recommended that a Council on Medical Education be established. The Executive Board, at its June meeting, directed staff to present a plan for creation of the proposed Council. Staff prepared a plan for a Council on Medical Education composed of the Committee on Medical Education and representatives from the Committee on Scientific Program, Committee on International Child Health, the Committee on Standards, PEDIATRICS, the Office of Manpower, the Department of Committees and the Department of Educational Affairs. Functions of the Council would include long range planning of educational programs and projects of the Academy, coordination of education programs within the Academy, a consultative and advisory relationship to the Executive Board, Councils, Committees and Chapters of the Academy, and the development of joint statements. Dr. Gerald Hughes of the Department of Educational Affairs reported on the plan at the April, 1974 Board meeting. The Department saw the plan as an excellent opportunity to remake the Committee on Medical Education. The Board was upset with the Committee at that time over lack of progress on continuing medical education initiatives. However, several Board members felt that the Committee on Medical Education should pass on it and it was referred to the Committee. The Committee reported back in June with recommendations and duties on the composition of the Council. The Committee also recommended that the Committee remain as is. The Board accepted the recommendations.

    The Council on Pediatric Education commenced operations in 1974. In 1980, it appears to have been sunset as it disappears from the Fellowship Directory. Board Minutes for 1980-1981 are silent on its fate. However, ACBOE was organized at that time, and in January, 1982, proposed that a new Council on Pediatric Education (COPE) be organized. It would be composed of the chairs of ACBOE, and of the Committee on Scientific Meetings, and the Editors of PEDIATRICS and PEDIATRICS IN REVIEW as well as some outside representatives. The Executive Board approved the proposal in March, 1982. In June, the Board directed that the chair for COPE be the chair for ACBOE. The Board directive to COPE declared that the Council was re-established in order to provide a forum whereby the Academy’s medical educational programs can be reviewed on a periodic basis. The Council was to be advisory to ACBOE. COPE was to meet on an annual basis, review Academy medical educational programs including its meetings and CME courses, PEDIATRICS, PEDIATRICS IN REVIEW, the PREP program, PEDIATRIC UPDATE, and TEACH-EM TAPES, make recommendations for change about educational trends, and consider new or alternative means by which the Academy can best serve the membership through continuing medical education. This Council soon commenced operations. Every year, it held a retreat, usually during the winter. In 1986, ACBOE proposed and the Board agreed to further changes in its composition to add three at large representatives and to have the chair chosen annually and not be a member of the Board. In My, 1988, ACBOE recommended a change in the directive to the Council. The Board approved the change in June, 1988. The new directive declared that the purpose of the Council was to act as a think tank regarding AAP educational policy and to comment and make recommendations on AAP educational programs, development of other educational programs and policies, and political efforts in relation to pediatric education. In 1999, the Academy underwent a general restructuring of Councils and Committees. Under the new arrangement, the Council on Pediatric Educationbecame the Committee on Pediatric Education with no change in function or membership.

    Committee on Pediatric AIDS

    On June 16-17, 1987, the Centers for Disease Control held a conference on pediatric AIDS. A number of Academy officers, members and staff attended the conference. The CDC sponsored the conference in behalf of the Academy in order to bring together officers of committees that were addressing the issue and to educate Academy attendees on the dimensions of the problem. The CDC also paid for Academy personnel to attend. In return, the CDC wanted the Academy to develop an action plan for dealing with pediatric AIDS. Academy committee chairs wanted the Academy to establish a Task Force to address the problem. The Executive Board, which met on June 26-27, promptly approved a proposal for an action plan and established a Task Force on Pediatric AIDS to carry it out. The Task Force met for the first time on August 17, 1987. Its first activity was to gather information and to advise the Academy. It soon expanded its role to establishing guidelines and recommendations for the care and treatment of children infected with HIV and drafting AAP statements on pediatric AIDS. In 1992, the Task Force was upgraded to a Provisional Committee on Pediatric AIDS. In 1995, it was upgraded to a full Committee on Pediatric AIDS.

    Committee on Nutrition

    This Committee started as a subcommittee of the Committee on National Defense in 1942. At a meeting of the Executive Board on June 7, 1942, Dr. Lee Forrest Hill suggested that the Academy produce a movie on the subject of nutrition. It was suggested that Mead Johnson & Company would be very glad to assist in this effort. The Board then approved the establishment of such a Committee with Dr. Joseph S. Wall as Chairman. The Committee operated as a subcommittee of the Committee on National Defense. The Academy was very concerned about problems of nutrition, especially for children of low-income families and children of servicemen. The Academy communicated its concerns to the War Production Board and the Office of Price Administration (which handled rationing). Mead Johnson dropped the movie project, but the Committee on Nutrition continued to address Academy concerns about the needs of low-income children. It is shown as a Sub-Committee of the Committee on National Defense in 1943. However, in that year, the Committee became a separate Committee. It became inactive in the late forties, making no reports. It apparently was discontinued in 1949 as it does not appear in the Fellowship Directories for 1950 through 1954. It should be noted that the Board also established a Committee on Vitamins in 1939. It published a small report, which was sold to members and the public. The Committee was sunset in 1944. There also was a Committee on Mother’s Milk Bureaus. At its meeting in June, 1940, the Executive Board rejected a suggestion that the Academy develop standards for Mother’s Milk Bureaus on the grounds that the Academy had enough to do. However, at the November, 1940 meeting, the Board voted to establish a Committee on Mother’s Milk Bureaus to draw up standards and submit them, as well as investigate present standards in connection with the Mother’s Milk Bureaus. The Bureaus sought to encourage mothers who had more milk than their infants could consume to sell it to mother’s milk bureaus. The milk could then be given to sick infants or other infants in need of it. The Committee died in 1949 because mothers refused to breast-feed or even to donate or sell their milk. They preferred the convenience of bottle-feeding.

    Issues regarding infant nutrition arose again at the April 3, 1954 meeting of the Executive Board. Letters from Drs. Clement A. Smith and Charles D. May concerning nutrition were read at the meeting. Dr. Harry Bakwin then moved that a Committee on Nutrition be established. Dr. William Weston seconded the motion and the Board approved establishment of the Committee. Dr. Crawford Bost said that the Committee would be concerned with data concerning allowances and requirements and also in making comments upon practices in infant feeding. Dr. Roger L. J. Kennedy said that the points made in Dr. May’s letter, plus the point the pediatrician on the National Research Council and the Council on Nutrition and Foods in the American Medical Association, as well as many others, may welcome the information that is compiled by this Committee, directives should be fairly well formulated.

    The Committee on Nutrition was soon organized, and it soon started making its reports and issuing statements on nutrition for children of various ages. In 1958, it established a Technical Advisory Group to Committee on Nutrition composed of nutrition scientists from various companies to participate in deliberations as non-voting consultants. Their industry connections eventually became controversial. In 1968, the Committee on Nutrition established a Subcommittee to Advise the National Survey (1968-1971) to advise and interpret nutritional and medical data from the National Nutrition Survey. This effort was badly curtailed due to lack of funding and non-availability of clean data. In February, 1971, responsibility for direction of the survey program was transferred to the Center for Disease Control. In June, 1971, the Academy signed a contract with CDC formally providing funds for staff support and expenses of convening a committee to carry out an adequate review of data to be developed at CDC. Accordingly, the Committee to Advise the Ten State Nutrition Survey in 1971. It was sunset after it completed its work. Other organizations and agencies also sent liaison representatives to the Committee on Nutrition. The Committee also established subcommittees to handle specific contracts with the FDA.

    During the late 50’s, the Committee accumulated a considerable amount of information about commercial formula services. Members of the Committee met on February 9, 1962 with representatives of the American Hospital Association, the AMA Council on Foods and Nutrition, the FDA, the Children’s Bureau and state and local departments of health. It was agreed that a permanent organization with wide representation would be desirable to provide continuing guidance with respect to commercial formula services. Based on these recommendations, the Executive Board established a Committee on Formula Services, which commenced operations on July 1, 1962. It was a joint Committee of the Academy, the AHA, the Children’s Bureau, the American Public Health Association, the FDA, and the Public Health Service. The Committee functioned for several years. However, in 1967, the Public Health Service published a manual on Standards for Infant Formula Services. The Committee on Nutrition objected to some parts of the booklet, but the Public Health Service published it anyway “with the cooperation of the Committee on Nutrition of the AAP.” Dr. Stanley Harrison, Director of the Department of Committees, discussed this with Dr. Charles Lowe, head of the Committee on Nutrition and of the Committee on Formula Services. They thought that the Committee might write a letter to the editor pointing out the fact that the Committee had an important role to play in the development of this project but that they did not endorse everything that was in there. After further discussion, the Board voted to drop the Committee on Formula Services as an official Academy committee.

    In 1993, questions were raised at ACBOC about the Technical Advisory Group due to its industry connections. The Committee felt that the TAG representatives provided useful information. They were often more familiar with regulatory standards than were academicians in general. Prompted by allegations of conflict of interest and perceptions that the TAG has been part of the policy making process, the Executive Director and ACBOC expressed concerns over the policy governing TAG and the ability of the Academy to defend this operational relationship. ACBOC discussed alternative approaches that continued to allow for appropriate technical support for the Committee on Nutrition without identifying industry as an operational entity on the Committee. It was then agreed that the Committee would work effectively with the option of inviting consultants to each of its meetings on an as needed basis. ACBOC then recommended that the Technical Advisory Group be sunset. The Board agreed at the June, 1993 meeting. The Committee on Nutrition is probably best known for its manuals on pediatric nutrition. It also has issued statements over the years on various aspects of pediatric nutrition. The Committee also has a long history of contracts with the Food and Drug Administration in developing recommendations on various aspects of the nutritional needs of infants and children.

    Committee on Native American Child Health

    Certain early Academy committees sometimes dealt with issues of Native American Child Health in a minor way. They were primarily oriented toward issues of child health in the larger community (see especially Committee on Community Health Services and its predecessors). There was no committee specifically concerned with the health problems of Native American children until the sixties.

    On April 28, 1964, the Chief of the Division of Indian Health, Public Health Service, requested that the Academy form a Committee on Indian Health. On May 5, Executive Director Dr. Einor H. Christopherson, acting for the Academy, indicated sincere interest and suggested that the Division develop committee guidelines for consideration by the Executive Board. The Committee was officially established on August 25, 1964 and the Board approved at its meeting in October, 1964. All members of the Committee came from areas where there were the greatest numbers of Native Americans. The chair was from Oklahoma, while other members were from Alaska, Arizona, California, New Mexico, Utah, and Washington. The Committee made field visits to Native American communities in Western and Southwestern states and Alaska. The Committee explored health problems in these communities and set up programs to recruit pediatricians to work in these communities. It also conducted training programs for community health aides to work in the communities. The Committee also was involved with national conferences on Native American Affairs, which explored health and other problems of Native Americans. The Committee’s primary function was to advise the Indian Health Service of Maternal and Child Health needs. The Committee was unusual in that the Indian Health Service funded 50% or more of its expenses.

    In the early 1980’s, the Academy embarked on a campaign to cut costs by combining or eliminating committees. In 1981, the Committee on Indian Health was inactivated to allow discussions with the Indian Health Service regarding future committee activities. The Board directed the Committee to function via correspondence and a conference call. The Board was especially interested in possible establishment of “on demand” consultative service, whereby Academy experts in special areas of health could serve to provide advice to peoples and to the Indian Health Service. In December, 1981, ACBOC recommended that the Committee be deactivated and that the Committee on Community Health Services be directed to include Indian health in its purview. ACBOC also recommended that the Chair of the Committee on Indian Health continue to serve as liaison with the ACOG Indian Health Committee. The Board approved the recommendations and the new directive for the Committee on Community Health Services at its meeting in June, 1982 (see Committee on Community Health Services for its history up to the establishment of the Committee on Native American Child Health).

    Although the Committee on Community Health Services now handled Native American Child Health, it also had a number of other initiatives within its purview and could not devote full attention to the issue. In the years following the discontinuance of the Committee on Indian Health, there was a lapse in pediatric influence on the delivery of care to Native American children. The American Academy of Family Practice (AAFP) had a long relationship with the Indian Health Service (IHS). However, many pediatricians who had been long time providers of care on reservations now found themselves excluded from the delivery systems developed under the AAFP/IHS joint ventures. While they welcomed additional medical support, they felt that well-balanced preventive child health programs were being slighted in favor of adult oriented programs. When the Committee on Community Health Services realized that pediatric concerns were a dwindling influence within IHS, a meeting was convened between the Academy and IHS in February, 1984. Drs. William Weil and David Kaplan met with IHS officials to discuss the possibility of future work in the area of Indian health. The IHS suggested that the Academy would put up funding for a project where consultants in pediatrics would meet as a group to formulate plans and then provide consulting services to certain areas with concentrated Native American populations. The IHS offered to match Academy funds. It already had a similar relationship with other medical societies, notably the American Academy of Family Practice. ACBOPP approved the recommendation but the Board unanimously defeated it in January, 1985. However, ACBOPP came back again in April, and renewed its proposal, noting the reasons for the lack of pediatric influence on the delivery of health care to Native American children. This time, the Board unanimously approved the proposal.

    Soon afterward, the Committee on Community Health Services set up a Subcommittee on Indian Health. In 1991, it became the Indian Health Project Advisory Committee. In January, 1993, ACBOC recommended that the Indian Health Project Advisory Committee become the Provisional Committee on Native American Child Health. There was considerable debate when the issue came before the Executive Board at its meeting in February, 1993. Board members expressed concern about establishing another Academy committee focusing on one minority group. They also noted that funding would continue for the old project advisory committee. Nonetheless, they approved the new Provisional Committee in a close vote. In 1996, the Provisional Committee became the regular Committee on Native American Child Health.

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