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Beyond the Checkup:
Many Faces of Your Child's Pediatrician
by Gwenn Schurgin O'Keeffe, MD, FAAP
Last year I treated an adorable 6 month old infant girl in the ER for a cold. The EMR (electronic medical record) highlighted that the family had recently been to the ER for a variety of other common complaints: diaper rashes, colic, sleep and breastfeeding problems - all issues that could have been handled in any pediatric office. As this visit concluded, I mentioned that their pediatrician could help them with further issues. The baby's mother looked perplexed. "We have an appointment tomorrow with her pediatrician but that's for shots and measurements," she mentioned. That was my light-bulb moment with this family - they truly did not understand the full role of their pediatrician in their daughter's life. And, they are not alone.
People trek to emergency rooms for a variety of reasons:
- They are having a true emergencies or need urgent care after hours
- They are visiting the area and require medical care
- They falsely believe they will be seen quicker than calling their own doctor
- They don't truly understand all the services their doctor's office offers
Emergency rooms do treat all comers but the sickest get seen first and there is always a wait, in fact 4-6 hour on average. Visiting the ER for simple matters instead of your primary care physician is like calling a repairman if your TV remote stops working. For a child, there are a few disadvantages to ER visits. The wait time can be very difficult for kids and lack of familiarity with the setting and staff disarming. Luckily, most ERs are much more child-friendly than in the past but it is still a more intense experience for a child than visiting their own pediatrician.
Pediatricians are trained in the complete child - sickness and health. Knowing what your pediatrician is trained to offer you can help considerably in knowing what to do after-hours and in feeling comfortable with an ER visit should it be needed.
Here's an A to Z guide of the myriad of areas your pediatrician can help with for your kids:
a. Anticipatory Guidance (informing you and your child of what's to come next)
b. Behavioral and psychological concerns - including ADHD, potty training, and discipline
c. Concerns of abuse or mistreatment
d. Drugs - use, abuse and supplements (prescription, recreational, vitamins, herbal)
e. Eating and feeding issue
f. Fever and sick symptoms - sore throats, headaches, vomiting, diarrhea, rashes, ear aches, cough, and runny nose - and just about every sick symptom you can think of!
g. Growth and development
h. Hearing issues
i. Immunizations (shots)
j. Journal articles and web sites to help you learn more about your child's condition
k. Kid-specific issues for all ages
l. Laceration repair and suture removal
m. Monitoring medical problems - new and chronic
n. Negotiating the world of specialists - including the ER
o. Orthopedic issues including injury treatment and sports participation
p. Puberty and sexuality issues and counseling
q. Queries about anything worrying you about your child
r. Rashes
s. School issues and concerns
t. Travel advice
u. Use of drugs and other risk-taking behaviors of teens
v. Vision issues
w. Weight issues - too little, too much and eating disorders
x. X-ray ordering (including acute injuries!)
y. Your concerns about your child
z. Zeroing in on what's really important - our kids!
Logistically, it is important that your pediatrician's office provides the services you desire in a time-frame that works for your family. Here are the main questions to ask when evaluating your current pediatrics group and in helping you find a new group should that be needed:
- How far out do you need to call for an appointment for routine care?
- If your child is sick, will you get seen timely or get phone advice? (Timely=within 24hours for most situations.)
- What is the staff like - friendly, respectable, interacts well with your kids?
- How does your doctor handle differences of opinion or times when you are very worried about an issue?
- Does the office make you and your child feel important?
- Do you leave visits feeling satisfied and heard? And, if not, do you feel comfortable raising your concerns with your doctor?
- How does the office treat your child?
- Does your child like the doctor and staff?
- What happens after-hours, weekends and holidays? Who is available to answer questions?
- Have you ever thought about changing groups? If so, address your concerns or being researching options.
There are as many types of pediatricians and pediatric offices as there are colors in the rainbow. Ultimately, the goal is to have your child's pediatrician be the first health professional you consult in a time of crisis and the person who helps you care for your total child.
© 2005 - 2006 Pediatrics Now. All rights reserved.
PEDIATRICS NOW™ is a trademark of Pediatrics Now
Do you have a question for Dr. Gwenn? Ask now!
What's Related
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About the Author
 Pediatrician, Dr. Gwenn Schurgin O'Keeffe, MD, is a board-certified pediatrician and Fellow of the American Academy of Pediatrics. Dr. Gwenn is an experienced columnist, educator, and practicing pediatrician. Dr. Gwenn strives to write as if she were talking to a parent. As a parent herself, she knows how important it is to obtain information but also understand how precious little time parents have to find that information on the internet. Pediatrics Now was developed to fill that gap and provide a bridge between the parenting and pediatrics worlds.
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