“The lion ate him!” said the two year old boy to his father. The father smiled and said, “Yes, that’s what happened in the story we read last night.”
Young children often say things that are out of context which leaves most adults befuddled as to what a child is talking about. The only adults that will understand are the ones who have spent time with the child and can fill in the context for the child.
A similar situation occurs for doctors when they see children at their practice. Doctors who have a long established relationship with a child and his family can make sense of issues beyond a child’s immediate health concerns. This can lead to better care and allows doctors to catch seemingly minor health issues before they become more serious concerns.
This diagnostic advantage disappears when a child’s health care is spread out among various providers who do not communicate with each other. This is why it is important for parents to establish a medical home for their children.
Medical homes are the primary place where a child’s health needs are met. Typically a medical home for a child is established with a pediatrician. A pediatrician can keep track of the child’s medical history including illnesses, injuries, physicals, and immunizations.
Based on this information, pediatricians can effectively coordinate with other professionals such as allergists, psychologists, and other medical specialists to ensure that a child’s needs are being met. This also increases the effectiveness of the treatments as services are not duplicated and follow-up services are more likely to occur.
The medical home begins to break down when a child gets “minor” services such as immunizations or physicals from other providers and the pediatrician is only consulted for more “major” medical concerns. The problem comes when a “major” issue occurs and the pediatrician is unaware of whether a child has received a particular immunization which could influence the course of treatment.
Not only does a medical home establish a centralized place for care, but children can establish a positive relationship with their pediatricians. Children typically enjoy being in settings that they are familiar with and with people who they have had positive experiences. Though a physical can seem like a “minor” service, it provides a chance for the pediatrician to find out a child’s interests and any concerns they might have. This can make it easier in calming a child down when he is feeling sick or injured later on.
A final point about medical homes is that they can serve as a touchstone for children and adolescents as they grow up. Other than their families, children have some of their longest relationships with their pediatricians. In some cases, the pediatricians may be in the child’s life from the day he was born until he becomes an adult. There are not many relationships children have in their lives like that.
Parents should make an effort to establish a medical home for their children. The on-going relationship and the increased effectiveness of health services is worth the effort.
This article was published in the Richmond Register daily Sunday on June 29, 2014.
