We all want what’s best for our children and it’s often a parent’s nature to worry. When it comes to having concerns about a child’s emotional or physical wellbeing, a mom or dad’s instinct usually is right on target. After all, who knows your child best? You!
Pediatricians and family practice physicians are on the front lines of health care, there to handle a host of health issues from treating ear infections and giving immunizations to vision, hearing and other once-a-year screenings. But when something with your son or daughter doesn’t seem right to you or to your pediatrician, it might be time to call for reinforcements and see a pediatric specialist.
What is a Specialist?
Pediatric specialists are pediatricians or surgeons who have additional in-depth training of a certain body part such as the heart or organ system like the digestive tract. They receive anywhere from two to seven years of further training in the specialty area they have chosen, such as gastroenterology, neurology, cardiology, ophthalmology, otolaryngology (ear, nose and throat), hematology/oncology, pulmonology, and endocrinology. Because these specialists are experts in their particular area of focus, they know how to manage and treat complex health issues that pediatricians may not feel as comfortable handling.
Some parents are fearful about bringing up the notion of seeing a specialist because they think it’s disrespectful to their child’s doctor. Others have no qualms about mentioning it but the bottom line is that your child’s primary care doctor wants you to ask questions because you’re a vital part of your child’s health care team.
“As a pediatrician, my job is to treat the whole child and the rule in general pediatrics is that a lot of pediatric health conditions can be treated by us. However, when I have exhausted all of my resources, or the child has a complex medical problem, I feel more comfortable recommending a specialist,” said Tracy Tyson, MD, a pediatrician with Orange Park Pediatrics, affiliated with Baptist Primary Care. “A parent’s job is to be their child’s advocate. I get two minutes in the room and a set of vital signs, so I don’t always know what’s normal for your child. I learned early in my career to listen to what parents have to say because I’ve seen their concerns result in the detection of conditions that may not have been discovered until later.”
What Conditions Require a Specialist?
The American Academy of Pediatrics (AAP) has specific referral recommendation guidelines to help general pediatricians determine when and where to refer patients out for special pediatric specialty care. Dr. Tyson says that common ailments that require a referral to a specialist include Asthma that is severe and cannot be controlled, chronic diarrhea for more than six weeks that cannot be diagnosed with an extended workup, developmental delays, persistent ear and sinus infections, growth issues that include failure to thrive, bedwetting more than three days a week over age eight, and diabetes.
“Anything that lasts more than six weeks is considered chronic and may require a specialist’s diagnosis and care to resolve,” said Dr. Tyson.
A good example of a common ailment is chronic ear infections. If a child has three within six months or more than four in a year, a referral will be made to a pediatric otolaryngologist (ENT) who is trained to care for ear problems. In cases where a child is suffering from chronic infections or has fluid behind the eardrum, an otolaryngologist can place ear tubes to help equalize the pressure in the middle ears and drain the fluid.
ENTs also perform tonsillectomies and adenoidectomies. “The most common reason for the removal of tonsils and adenoids is sleep-disordered breathing,” said Robert Sprecher, MD, pediatric otolaryngologist with Nemours Children’s Specialty Care, Jacksonville and Wolfson Children’s Hospital. “Sleep-disordered breathing caused by enlarged tonsils and adenoids can prevent children from getting enough sleep, which can translate into poor school performance and a higher incidence of anxiety, depression, aggressiveness and other conduct problems. A good night’s sleep is important.”
A less common example is congenital heart disease. Jose Ettedgui, MD, a pediatric cardiologist with the University of Florida College of Medicine – Jacksonville, said parents’ concern about symptoms or a sense that something isn’t right with their child is how many children end up in his office.
“Congenital heart problems can go undiagnosed because many are silent and have no outward signs or symptoms,” he said. “With these conditions, fast breathing, a rapid heartbeat and complaints about chest pain or passing out with exertion are all red flags that parents can pick up on.”
Such observations can save their child’s life.
Seeing a Specialist
Unless you have a Preferred Provider Organization (PPO) plan or your insurance waives referrals, the primary care provider needs to issue a referral to a pediatric specialist. But Dr. Tyson notes that seeing the primary first can calm fears, get questions answered and, in the case of an actual problem requiring a specialist’s care, make sure the proper workups are done prior to the specialty appointment.
“This saves time, money and sometimes it gets a child on the specialist’s calendar much sooner,” said Dr. Tyson. “Plus, it’s better for your child if his or her doctors are communicating and coordinating from the beginning.”
Thank you to Wolfson Children’s Hospital for sponsoring this post.
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While I’m sure the thought of seeing a specialist can be intimidating and frightening to any parent, seeing one can also help ease their mind so they can figure out if anything serious is going on. Thank you for sharing this insight!
Thanks for your comment, Rachel! And for reading our blog post.
Nice Blog! After reading this blog I got brief idea about our how to choose best pediatrician. Thanks for sharing your valuable information these are very helpful for me. Please keep update the blogs like this.
Thanks for your message, srikanth!
This is some really good information about pediatric exports. My little nephew has a few heart problems. My sister is wondering if he should go see a pediatric cardiologist. I liked that you pointed out that specials want you to ask a question and I know that would make my sister feel a lot better.
Thanks or your question, Ms. Baker. Your nephew’s pediatrician may have a recommendation for you for a pediatric cardiologist on the medical staff of Wolfson Children’s Hospital. More info on our heart program is available at http://wolfsonchildrens.org/centers-of-distinction/heart/Pages/default.aspx
It’s good to know that there are these specialty pediatricians that can treat children with asthma, chronic diarrhea, diabetes, bedwetting, growth issues, or any issues that last for more than six weeks since it can be considered as chronic as you’ve mentioned. That’s perfect since my nephew is known to both have asthma and fear of doctors. I’ll refer this article to my brother so that he can try to see if they can consult him with a specialty pediatrician. Hopefully, everything goes well. Thanks!
Wow, this article has a lot of good resources for childcare, and I actually hadn’t thought of checking to see if the hospitals in my area have Pediatric specialist we can look at.