Handicapped children have special rights under federal law. School physicians are often caught between the needs of the handicapped child and the limited resources of the school district. Special education programs and facilities for the handicapped are expensive. If the school district employs only one speech therapist, the physician will be pressured to limit the diagnosis of significant speech defect to the number of children this therapist can treat. Since handicapped children are protected by federal law and seldom pose a threat to other students, the school physician’s duty is clearly to the student rather than to the school. The diagnosis of articulation defect must be based on an objective evaluation of the speech performance of the individual child, not on the willingness of the school to provide services.

Physicians must not compare one child with another to determine which will be referred for special help or care. If both children require therapy, that should be the physician’s recommendation. If there are not sufficient resources to provide for all the handicapped children, then it is the duty of the school district to find the resources. The physician cannot legally or morally withhold a diagnosis in order to withhold special care. Irrespective of state law immunity for schools, a physician who did so as a matter of routine might be sued under the federal civil rights act for violating the child’s rights.