Procedures in Peds?

[californiasky]

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There probably aren't many, but what procedures can general pediatricians do? Are pediatricians trained to do procedures in residency?

 

[AF_PedsBoy]

The ones I've done so far are LP, circumcision, needle thoracostomy, suprapubic tap, umbilical line, cryotherapy for warts, laceration repair with suture/glue/and staple. My coworkers have also done intubations, blood draws, line placement (other than ubilical), chest tube placement. I'm sure there are tons I haven't encountered yet

 

[KidDr]

There probably aren't many, but what procedures can general pediatricians do? Are pediatricians trained to do procedures in residency?

In residency, I've done LPs, blood draws (venous and arterial), IVs, central lines, arterial lines, umbilical lines, intubations, suturing & administering local anesthesia, I & D, bladder caths, suprapubic bladder taps, cryotherapy for warts, NG placement, foreign body removal (from ears, etc), and arthrocentesis. I haven't learned how to do circs, because the OBs do them at all the sites where I've rotated through the newborn nursery.

In terms of which procedures general pediatricians keep up on, it really depends on their scope of practice. It seems like most I've worked with routinely do circs, cryotherapy, and FB removal. Many also do suturing. As for the more invasive procedures, it depends on how much hospital time a general pediatrician does. In general, the more hospital time, the more procedures. It's obviously a different story for some of the peds subspecialists (NICU, PICU, and EM especially), who routinely do lots of procedures.

 

[DCHawk10]

I've heard of Family physicians taking CME courses in Allergy Evaluation and Testing (prick tests, serial dilution titration, and RAST testing) and incorporating it into their practices. Is this something General Pediatricians do as well? Do you know of any general pediatricians that do allergy testing?

 

[californiasky]

I've heard of Family physicians taking CME courses in Allergy Evaluation and Testing (prick tests, serial dilution titration, and RAST testing) and incorporating it into their practices. Is this something General Pediatricians do as well? Do you know of any general pediatricians that do allergy testing?

I remember when I was little and had allergy skin testing, it was at my general pediatricians's office. don't know what the deal is these days...

 

[californiasky]

so do general pediatricians usually round on their own patients in the hospital? or do most let the pediatric hospitalist do the work? I guess it depends on where you practice right?

what kind of other procedures can u do in the office to increase revenue? (wart removals, FB removal...)

 

[KidDr]

so do general pediatricians usually round on their own patients in the hospital? or do most let the pediatric hospitalist do the work? I guess it depends on where you practice right?

what kind of other procedures can u do in the office to increase revenue? (wart removals, FB removal...)

Some do uncomplicated suturing and I & Ds in their offices. Other things that I can think of off the top of my head that general pediatricians often bill for (all are usually done by the MAs, not the docs): administering immunizations, ear irrigation (for cerumen removal), measuring PFTs, giving nebs, and so on. Some (especially those in adolescent med) do a lot of pelvics and can bill for that (and any associated tests required).

But overall general peds isn't by any stretch of the imagination a high-procedure specialty. Most of the general peds I know spend far more time doing general physicals and ADHD evals than procedures. Hence part of the reason it doesn't pay as well. But they're really good at what they do and it drives me crazy that you get reimbursed something like $200 to I & D an abscess (which probably took about 5 minutes) but if you spend an hour talking to a depressed teen you might get reimbursed $50. But if you like peds and also like procedures don't let that defer you--if you go into PICU, NICU, or EM, you'll do lots of procedures.

 

[fourthyearmed]

LPs, LPs, LPs, and more LPs (in residency anyway)! I think in general private pediatricians do better to refer patients needing procedures to the ER/hospitalist/housestaff because they would probably make more money seeing 3-4 more patients in the time the procedure would have taken.