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Referrals to a Pediatric Specialist

Pediatric Basics


Updated April 02, 2008

No matter how experienced, talented, or thorough your pediatrician is, there will likely come times when you have to take your child to a specialist. For example, your child may have severe asthma that is difficult to control and he needs to see a Pulmonologist, or you may be having a hard time treating his eczema, and he needs to see a Dermatologist for more help and advice.

But what type of specialist should you see?

Even when the decision seems clear, like seeing a Dermatologist for eczema, it becomes a little more complicated when you consider that there are specialists for both children and adults.

While most of the specialists for adults also treat children, there are also specialists that only take care of children. These pediatric specialists, in addition to their training in general pediatrics, undergo additional training in their specialty. So a pediatric Gastroenterologist, after medical school, has trained for three years in a pediatric residency program and has then completed an additional three years of training in Pediatric Gastroenterology. On the other hand, an adult Gastroenterologist trains for the same amount of time, but spends most, if not all of that time taking care of adult patients. Or consider that an Emergency Room doctor in a general hospital may be taking care of your child and have absolutely no pediatric training.

Not all pediatric specialists are pediatricians though. Most of the surgical pediatric specialists, such as Pediatric Urologists, Pediatric Surgeons, and Pediatric Ophthalmologists, although they have specialty pediatric training, are not pediatricians. Other 'surgical' pediatric subspecialists include those who specialize in Anesthesiology, Heart Surgery, Neurosurgery, Otolaryngology (Ear, Nose and Throat specialist), Orthopedics, and Plastic Surgery.

Most of the 'medical' subspecialists, including Pediatric Allergists, Pediatric Endocrinologists, and Pediatric Nephrologists, are also Pediatricians. There are also pediatric subspecialists in Critical Care, Cardiology, Developmental Pediatrics, Emergency Medicine, Genetics, Hematology and Oncology, Infectious Disease, Neurology, Radiology, Rheumatology, and Sports Medicine.

Why should you choose to see a pediatric ppecialist? According to the American Academy of Pediatrics, it is because 'children are not just small adults. As growing individuals they have special needs related to growth and development. In addition, their psychological needs are different from those of adults.'

Take for example this report, How often are spectacles prescribed to "normal" preschool children?, in the July 2004 issue of the Journal of the American Association of Pediatric Ophthalmology and Strabismus, which found that almost 20 percent of toddlers were misdiagnosed and prescribed glasses when they saw an Optometrist or General Ophthalmologist. This probably occurred because 'they apply adult standards to children,' unlike a Pediatric Ophthalmologist who would likely be more knowledgeable about the guidelines of the American Academy of Ophthalmology and American Association for Pediatric Ophthalmology and Strabismus.

However, the best specialist for your child is not always the one who has pediatric training. You must also consider the doctor's level of experience in taking care of children. For example, most General Surgeons have a lot of experience treating kids with appendicitis or repairing a hernia. They may not have as much experience treating a infant with pyloric stenosis though. So it is important when seeing a non-pediatric specialist to ask about how many children they usually take care of and if they have treated many children with the same condition as your own child.

And of course you have to consider the availability of pediatric specialists in your area. Since most practice in larger cities, parents in more rural areas may not even have access to a Pediatric specialist unless they travel for long distances, which may not even be an option if you have a very sick child.

And don't forget your pediatrician, who can be your best resource when looking for the best specialist to take care of your child. Even if you don't need an official referral to see a specialist, your should always discuss it with your pediatrician so that you will see somebody that they know, trust, and respect.

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