ER Doctors are not Pediatricians

I am wondering if pediatricians are no longer seeing patients after hours since many parents appear to be going to the ER with a child's problem rather than calling the child's doctor. ER doctors are usually well-trained in emergency procedures and trauma, but many have had little training in common childhood problems. Instead, they may order many unnecessary tests and often come up with a diagnosis that does not fit the child's symptoms. I am hearing more and more from parents in both the U.S. and other parts of the world that a diagnosis has been made based on a single abnormal lab test. Lab tests can be wrong or with the test, CPK, it can be markedly elevated if a child is crying or moving. If a child is seen for a stomach ache, I would first ask about constipation, the child's diet, urinary symptoms, allergies, or a foreign body. I certainly would not think of hepatitis or other major problems. One ER doctor even made the diagnosis of muscular dystrophy on the basis of an elevated CPK. Then if a child is referred to a neurologist who has not had neuromuscular training, the problem can get worse. Genetic tests are not reliable unless they fit the child's symptoms, history and family history. A great deal of emotional pain and grief could be avoided if ER doctors received more pediatric training during their residencies. Sadly, this does not seem to be happening. Even pediatric residents often receive training more focused on abnormal and unusual problems rather than everyday childhood disorders. Constipation and urinary symptoms are common in children and a foreign body can be a a possibility. An X-ray could easily identify the problem. I have an X-ray of a little child's abdomen showing a razor blade. Little children will swallow almost anything or stick foreign objects in every orifice!

Comments

[Kacy]

Very true, but sometimes as you have mentioned pediatricians are not always available.