History
The Division of General Pediatrics was one of the founding Divisions in the Department of Pediatrics, when the Stanford University School of Medicine moved from San Francisco to Palo Alto in 1959. The Division’s initial clinical and educational responsibilities were centered in the General Pediatrics Clinic, where students from the Stanford University School of Medicine had their initial introduction to the specialty of Pediatrics and young physicians in the pediatric residency training program of Stanford University Hospital had an opportunity to work under the supervision of faculty from the School of Medicine. As the size of the Department grew under the leadership of the late Irving Schulman, M. D. , (Chairman of the Department of Pediatrics from 1972-1991), the Division was asked to take on an increasing role in the care of patients hospitalized at the Children’s Hospital at Stanford and at the Stanford University Hospital, including newborns and hospitalized children and adolescents. From the beginning, the Division’s clinical practice was open to all children, which made it a key component of the community’s safety net for children in the region. As its clinical role expanded, the Division also took on primary responsibility for the training of pediatric house staff in their Pediatric Continuity Clinics, Newborn Nursery and General Pediatric Ward Services. Concurrent with the increase in its clinical and educational role, the Division’s research also expanded with a focus on childhood obesity, health services, and underserved children. With the opening of the Lucile Packard Children’s Hospital in 1991, the Division of General Pediatrics further grew from its initial size of 5 full time faculty to its present complement of 48 faculty. The Division’s growth has included the development of an inpatient hospitalist program that now provides care of hospitalized patients at the Lucile Packard Children’s Hospital, as well as in satellite inpatient units at the El Camino Hospital, in Mountain View, and the Washington Hospital, in Fremont. Faculty in the Division also provide pediatric care in the Lucile Packard Children’s Hospital Pediatric Weight Clinic and at the Ravenswood Family Health Center, a community clinic in East Palo Alto. Over this period of development, the Division was headed by Dr. Ruth Gross (1973-1984), Dr. Lawrence Hammer (1985 to 1995), and Dr. Fernando Mendoza (1996 to present).
As an academic unit, the Division had continued to expand its scholarship to address the needs of children in our diverse society. Added to its initial research focus on childhood obesity, health services, and underserved children, divisional faculty have developed other areas of scholarship including quality improvement, child development, health policy, advocacy, medical education, and informatics. These research foci have developed to meet the special health needs of children. For example, as childhood obesity has become epidemic, divisional faculty have provided national and international leadership in this area. The changing health care environment for children, particularly those who endure health disparities, has led faculty to research how to improve care from hospital to community, including improving the quality and safety of care, developing a more functional medical home with improved communication between and among families and their multiple health care providers, reviewing how resources are allocated for children’s health care, and trying to better understand the determinants of children’s health, based upon family, community, immigrant status, and social class characteristics. The Division has a strong commitment to translate pediatric research into effective programs and policies to improve children’s health.
As the Division has achieved regional and national prominence over time, its commitment to advocacy for children has grown. Its faculty have taken national leadership roles in pediatric societies, governmental committees, and private non-profit organizations all focused on improving the health and lives of children and their families. Yet, the legacy of leadership is set in place the leadership for the next generation. This has been a characteristic of the Division over the past decades and one which has become a core component of the Division’s mission. The Division, Department of Pediatrics, and School of Medicine are providing leadership development at all levels, from medical students to residents to fellows to junior faculty. Among those efforts, one which has been nationally recognized, is the General Pediatric Advocacy Program headed by Dr. Lisa Chamberlain. This program teaches residents to both be advocates and scholars, and better understand and act upon the needs of children. It is a program which is setting the standard for pediatric leadership in the 21st century.
The history of the Division of General Pediatrics has been linked with the history of academic general pediatrics, developing from a primarily clinical-educational entity to one that also uses scholarship to improve the health and lives of children. For ten years, the Division served as a site for the Robert Wood Johnson Foundation’s Fellowship Training Program in General Academic Pediatrics. This Fellowship Program trained a new generation of leaders in academic general pediatrics, with a focus on the child as a whole rather than on the disease process. This emphasis includes understanding the child’s family and community environment, determining how institutions and policies affect children’s well-being, and modeling wellness as the interaction among the child’s biology, environment and culture. With this history, the Division of General Pediatrics is meeting the needs of children in the 21st century.
