Hail to the Chief

Dr. Stephen Edwards of Raleigh was elected the president of the American Academy of Pediatrics (AAP) in October 2002. The AAP is the nation’s largest pediatric organization, with a membership of more than 55,000.

A native of Spring Hope, Edwards attended Davidson College, Duke University School of Medicine and trained at the Emory University pediatric program. He is past president of the AAP North Carolina Chapter.

For more than 30 years, he was a managing partner at Raleigh Children’s and Adolescent Medicine. He retired in June 2001. He and his wife, Sylvia, have three children and six grandchildren. Sylvia still works full-time at the pediatric office.

Carolina Parent recently talked with Dr. Edwards about his new position and about pediatrics today.

How did you become interested in becoming a pediatrician?

As part of a scout merit badge, I went around for the day with a doctor in Spring Hope and started thinking about a career in medicine. Then, in the 10th grade, I was in an automobile accident and had moderately serious wounds. My head hit the windshield, and I was unconscious and hospitalized for several weeks. That was the time I started thinking more seriously about medicine because I saw some of the good things that can happen. It was not until my senior year at Duke that I decided on pediatrics. It was a pretty positive environment. For most children, no matter how sick they are, they get well and have a long and happy life ahead of them.

What do you like most about pediatrics?

I enjoy the interaction with parents and kids. It is a real honor to be selected by families to participate in the health care of their children. For most families, their children are the most valuable possessions that they have.

What are some of the biggest changes to hit the field of pediatrics over the years?

One of the most striking changes is the percentage of fathers who take part in the health care of their children. I am sure fathers always did, but in the early years we rarely saw fathers come into the office. By the time I retired, at least a fourth of the visits, the father brought the child in by himself or came with the mother.

Also, the entire system is different. You never used to ask people if they even had health insurance. Suddenly, you had to be sure they had the right health insurance in order to be seen in your office. You have to be careful to jump through all the right hoops including referral, hospital admittance and other processes. These were things you never even thought about in the early days.

Children haven’t really changed through the years, but teenagers have. They are much more open about discussing such things as drugs, sex and alcohol. I am sure teens were engaging in those activities in my earlier years, but they would never have talked about it.

How should parents select a pediatrician?

First, it is important to make sure the pediatrician is board certified. Then, parents should check the networks the pediatrician is involved in, such as hospitals and other referral networks. Parents want to be sure someone is available to talk with them 24 hours, seven days a week. They should visit the office and see what the atmosphere is like. You want the people in the office to be warm and friendly. When I call an office, I want to hear a voice on the other end of the line. A lot of good offices do have answering systems, but it is important to me to talk to someone. Parents – especially new ones – often just want to talk about what is going on with their child. Often parents are not sure if it is a real emergency, and they are calling the pediatrician’s office to find out. You can’t learn that from an answering machine.

Do you have any advice for new parents?

The most important things are to trust the pediatrician to be a partner in the rearing of your children and to trust your own instincts. Early on, parents need to call the office a lot more than they do later. If something that the pediatrician says doesn’t make sense, call back and double check. Communication with the pediatrician is very important.

What advice do you have for the parents of teenagers?

Parents need to set rules and guidelines and let their teenagers know firmly their thoughts on issues such as smoking and sexual relations, and that they are always available for communications. Then, parents have to back off a little and let the teenagers work some of these things out for themselves. Teens have to do this in the context of knowing where parents stand and with the confidence that their parents are there to support them and point out if they are going in the wrong direction. Parents need to let go some, but they can’t let go too much.

How were you elected president of the AAP?

A national nominating committee invites between eight and 10 people to interview for the job. The committee then selects two people to run. The two candidates write a regular column in the monthly magazine on different issues. They also travel around the country, speaking at various meetings. The two candidates must attend the events together. The campaign starts in September and ends with the voting in June. The actual presidency is one year, but you serve as vice president-elect for about six months, then president-elect for a year, so the whole process is about 2 1/2 years.

What are the duties of the job?

As president, I coordinate and lead the organizational activities. These run the gamut, but much of it is political work in Washington relating to children’s health and laws. On many issues, it is my job to try to form a consensus among people from all across the country. Our headquarters is located in Chicago, and we have a smaller office in Washington, DC.

There is a lot of travel involved. I was in Washington twice in one week, am spending a whole week in Chicago, and then am heading to California for several days. One day in Washington, I met with leaders from the six major national pediatric organizations. Another day, I was with 40 major players in the field of children’s health care to build an agenda of issues to move forward through Congress. I also try to keep in touch with pediatricians in the various states and learn about their problems and see what the national organization can do to help.

What do you want to accomplish during your term?

The AAP is working to see that every child in the country has access to health care. I would like for this to be my legacy – that I helped make this happen. We are beginning to hear more on the political landscape about the importance of health care for children. I hope it will gain even more attention during my term.