Rx For Parenting Today

Holiday Care in Emergency Rooms

Now that many doctors do not see patients on holidays, it is important for parents, and others, to know how to get the best medical care in an emergency room. ER doctors are trained  to take care of trauma patients, not everyday medical problems. I remember seeing a child in an ER on a holiday when the ER secretary was frantically trying to find an eye doctor for a patient with an eye injury. Every eye doctor who was called was not available. I knew a wonderful ophthalmologist, who had seen many patients for me, so I called him at home. He was  excellent.  He asked the patient's family to meet him in his office and took care of the problem. I was his children's pediatrician and knew he would respond to my call if he was in town. 

Holidays are generally very busy in ERs and should not be used for general medical care and certainly not for children with problems, unless it is trauma.  Now that we have networks and HMOs, a surgeon who is called to take care of a patient who needs stitches may not be on the patient's networks or HMO list. There have been incredible accounts of surgeons who charged outlandish fees for putting a few stitches in a patient. I worry about how money has become so important to so many doctors. 

ER doctors should not try to handle problems  for which they do not have adequate training. If a small child has severe croup, a pediatrician or pediatric anesthesiologist should be called. Many hospitals do not have these doctors on call and also do not have the necessary pediatric equipment to handle problems needing for example a tube for inserting in a child's windpipe or trachea. Before I started my own practice and took other doctors' practices for short periods, I always carried a big black bag with a lot of equipment, including pediatric endotracheal tubes. Fortunately I never had to use one. If you have to take a child to an ER and get to feel uncomfortable about what the ER doctor is telling you, I would find another hospital. 

Facts Parents Need to Know about their Children's Doctor or a New Doctor

I am frequently amazed at how little some parents know about the qualifications of their children's doctor. Questions I would want to have answers to are: Is the doctor an M.D. or a  D.O. Also is the individual a nurse practitioner with a doctor of nursing degree?  Many states now are allowing these individuals to practice without being supervised by an M.D. That to me is very scary. They simply do not have the necessary training to do this.

Once you have decided on a doctor you can get some answers to my questions by checking the individual out on the Internet or calling the Board of Medical Examiners in your state if the individual is an M.D. My next  question is if the M.D. is Board Certified or Board qualified. Anyone can call themselves a pediatrician but that does not  mean they have the necessary training. Where they went to medical school is also  good to know. 

Once you have chosen a specific doctor you need to ask if he or she will meet you in the ER in an emergency or if they just refer you to the ER doctor. Most E.R. doctors do not have the necessary pediatric training to take care of anything except trauma. If a child has to be hospitalized does the doctor come to the hospital daily to see the child or twice daily as I  did or  is the care left to a pediatric hospitalist. That is very scary to me and something I would never have done.

Also does the doctor answer his or her own calls after hours or leave that to a nurse or non-medical person. The answers to these questions could mean a child's life or serious problems. Children can become ill very quickly and need the best care possible. They are  precious and our future. 

Medical Care for Children with Special Needs

Because medical schools often do not include subjects about caring for children with special needs, pediatricians and family doctors are often at a loss about what to do with a child who has cerebral palsy, spina bifida or other disorders. Thus parents  usually have  to be the ones to find the medical care their child or children need. Each state has a special program for these children. Special services are provided, such as physical and occupational therapy, some equipment and clinics. This does vary from state to state. In my first book, Raising a Handicapped  Child, I give the number for each state office that a parent can call for information. I also give this list in my book for  children with neuromuscular disorders.   If you know an older parent who has a child with a disability this individual can often be your guide to getting help. Community clinics or those run by different organizations may or may not provide good care. Many do have social workers who can be very helpful. Agencies associated with different disorders may be helpful with referrals  but I would always check out these referrals carefully.  

There are two good agencies that can help. One is the Patient Advocate Foundation at 1-800-532-5274 and the other is Family Voices at 1-888-835-5669. If there are any legal problems the Protection and Avocation organization is excellent. Their number is 1-888-835-5669. They have lawyers on staff who can be very helpful. 

The Internet can be a good resource for information but I would be very careful about some of the information that is given. It is always wise to check and double check both on doctors, their credentials, different agencies and treatments.  

When Children are Included in an Adult Party or Visit to Friends

I am often amazed when small children are included at an adult party or visit to friends that their parents often don't bring toys or special foods for them. I guess they expect the hosts or friends  to have things for the children. I have spent a great deal of time at different events watching out for little children to be sure they didn't get into any harm. It is so easy for a child to slip away and get into serious trouble. This is particularly true of children on the autism spectrum.

I have had to care for little children who almost drowned, were injured or tried to slip away and almost were injured. I always took special toys or snacks when I was traveling with my children, when they were small. I never expected the families we visited or the parties I attended with the  children to expect someone else to care for them.

Now that the holidays are approaching, if you want to enjoy yourself, it would be wise to hire a teenager, you can trust, to go with you and watch out for the children. A teenage boy made a real difference in a child's life at a wedding recently when the single mother paid absolutely no attention to her autistic son. This was in a large house and yard  where he easily could have come to serious harm. He also could have ruined the wedding. Thinking ahead and being aware of potential problems with small children always pays off. Happy Holidays!