Look to pediatrician first, not ER in most cases
By Gwenn Schurgin O’Keeffe, MD, FAAP
Your Kid’s Health, The Salem News
February 2, 2004

The other day I treated a cute baby for a mild cold. The parents had recently brought the infant to the ER for rather routine pediatric complaints – diaper rashes, colic, sleep. I helped with the cold and rattled off a few things to look for to follow-up with their own doctor like fever, fussiness, and poor feeding. The baby’s mother looked at me perplexed and mentioned “well, we have an appointment tomorrow with her pediatrician but that’s for shots and measurements”. I smiled and asked her if she realized that her doctor’s office was there for sick visits as well, and had an answering service. She laughed and said, “Wow. You mean I did not need to wait the past 3 hours for this?”

Emergency rooms across the country find the same pattern of visit-type. While many people use the ER appropriately, there are many who use it as their “primary care” facility. There are many reasons for this: their doctor’s office may be too far from home to get to realistically; many have a misconception that ERs are “faster” only for people to find themselves waiting many hours instead; and many just don’t know what a “primary care doctor” really can provide. Keep in mind that you will always get seen if you come to an ER but the sickest get seen first by design and there is almost always a wait. Why wait to see a doctor you hardly know when you can take your child at a designated time to an office you and your family are familiar with?

Did you know that:

• your pediatrician’s office is available even after hours to answer questions.
• many pediatrician’s offices have early a.m., evening and weekend appointments.
• your pediatrician has someone covering when on vacation.
• your pediatrician can help you with: school issues, normal growth and development,

hearing and vision concerns, simple lacerations and suture removal, fever evaluations, care of injuries including broken bones, discipline and sleep issues, feeding and eating issues, sore throats, headaches, vomiting, diarrhea, rashes, ear aches, cough, runny nose – the list here is endless.

Keep in mind that doctors’ offices are not all run the same way, and not every type of practice works for every family. The goal is for you and your family to feel comfortable with the entire package. Some issues to consider when picking a pediatrician are: how large the medical group is; what the staff is like; how easy it is to get an appointment for a sick visit; how close the office is to your home; how much ancillary services the office has such the ability to run simple lab test or get x-rays; and the credentials of the doctor such as being board certified in pediatrics and being a member of the American Academy of Pediatrics. In addition to asking your doctor, both the AAP web site and the Massachusetts Board of Registration in Medicine can help you verify any doctor’s credentials.
Dictionary.com defines “primary” as: “the first in importance; first in a series or sequence; occurring first in time or sequence; serving as an essential component….”
So, you’ll know if the primary care system is working right for you when your child’s pediatrician is the first in importance for your child’s health and the first health professional you consult first when a crisis hits. And, if you’ve never thought of using a pediatrician this way, give it a try – I guarantee it’s out there and you won’t be disappointed by the results.

© 2005 Pediatrics Now. All rights reserved. PEDIATRICS NOW is a trademark of Pediatrics Now.

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