What do General Pediatricians actually do?

[Smooth Operater]

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Hello guys! I am learning about different speciality in medicine, and I am wondering what exactly does a general pediatrician actual do? Are they kinda like family physicians for little ppl? Can anyone here enlight me ? Thanks you 😛

 

[edmadison]

Hello guys! I am learning about different speciality in medicine, and I am wondering what exactly does a general pediatrician actual do? Are they kinda like family physicians for little ppl? Can anyone here enlight me ? Thanks you 😛

Exactly right (except that "little people are dwarfs, not children 🙂 ). As a practicing pediatrician, you will likely see 30+ kids a day in your office. Many will be routine well child check-ups, which are more counseling than anything else. You'll also see many many patients with viral syndromes. Lots of sore throats, painfull ears and GI upset. You will also be a dermatologist without the good pay and hours. Most of the ailments would resolve on their own without intervention. Your real tough task is separating the sick kids from the well -- who needs to go into the hospital. Depending on your practice, you'll freeze warts, I&D simple abcesses, sew up lacs and cast fractures. You will also typically manage your patients in the hospital (unless your hospital employs a hospitalist).

Ed

 

[notstudying]

Exactly right (except that "little people are dwarfs, not children 🙂 ). As a practicing pediatrician, you will likely see 30+ kids a day in your office. Many will be routine well child check-ups, which are more counseling than anything else. You'll also see many many patients with viral syndromes. Lots of sore throats, painfull ears and GI upset. You will also be a dermatologist without the good pay and hours. Most of the ailments would resolve on their own without intervention. Your real tough task is separating the sick kids from the well -- who needs to go into the hospital. Depending on your practice, you'll freeze warts, I&D simple abcesses, sew up lacs and cast fractures. You will also typically manage your patients in the hospital (unless your hospital employs a hospitalist).

Ed

Ed, you make it sound so tempting 😉. Right now (buried in the NICU), I'd give anything for an otitis! Sure would beat intractable PPHN in a patient who needs surgery.

The description is pretty good-there are many people who love general peds and have a great life-they enjoy watching the children grow up and getting to know the families. Another option in general peds is a faculty practice, or general academic peds. There you would see clinic patients a few 1/2 days a week (who tend to be medicaid or uninsured patients), often in a precepting role with residents, and then also do research, teaching, or community advocacy. You also have a few months a year on call, where you manage any clinic patients (or those with pediatricians who don't have priviledges at your hospital) admitted to the hospital. Most general academic pediatricians do a 2 or 3 year fellowship after residency.

 

[oldbearprofessor]

Ed, you make it sound so tempting 😉. Right now (buried in the NICU), I'd give anything for an otitis! Sure would beat intractable PPHN in a patient who needs surgery.

Hmmm...between Notstudying and Ed, there seems to be a good bit of dissing NICU these days around here! 🙄

C'mon, PPHN (persistant pulmonary hypertension, AKA PFC- persistant fetal circulation, by us old timers) is the most interesting disease in neonatology. We get to try everything, and when that fails, there's ECMO. In my early days....before ECMO, NO, oscillators, and the like, we used to do a LOT of all nighters hand-bagging babies to hyperventilate them. I remember doing shifts with RT's bag-ET tube for hours on end! I don't exactly miss that or suctioning ET-tube to mouth (for mec in the delivery room). 😛

Now then, so as not to be accused of hijacking another thread, I'll add a comment that general pediatricians may do very little neonatal care if they are in big cities or may do a lot of neonatology if they are in smaller cities and sometimes even in suburbia. Some general pedis regularly intubate and put in umbilical catheters, others haven't done it since they were on call in the NICU.

Take Care

"oldbearprofessor"

 

[notstudying]

Hmmm...between Notstudying and Ed, there seems to be a good bit of dissing NICU these days around here! 🙄

C'mon, PPHN (persistant pulmonary hypertension, AKA PFC- persistant fetal circulation, by us old timers) is the most interesting disease in neonatology. We get to try everything, and when that fails, there's ECMO. In my early days....before ECMO, NO, oscillators, and the like, we used to do a LOT of all nighters hand-bagging babies to hyperventilate them. I remember doing shifts with RT's bag-ET tube for hours on end! I don't exactly miss that or suctioning ET-tube to mouth (for mec in the delivery room). 😛

Now then, so as not to be accused of hijacking another thread, I'll add a comment that general pediatricians may do very little neonatal care if they are in big cities or may do a lot of neonatology if they are in smaller cities and sometimes even in suburbia. Some general pedis regularly intubate and put in umbilical catheters, others haven't done it since they were on call in the NICU.

Take Care

"oldbearprofessor"

OK, how many interns actually love their NICU time, with no moments of angst! It's really not that bad, but I have a couple of patients now who are frustrating; including the one with PPHN-a very interesting disease, which generally doesn't mean good things if you are a patient. And another who should be comfort care but whose parents aren't ready to let her go. That said, it is absolutely amazing how many of the premature, and especially very small babies have good outcomes-I expected it to be much worse. One of my most stable patients weighs under a kilo. It took me 2 days before I'd do anything but listen to his heart and lungs!

I promise I'll stop hijacking-just had to vent! 😉

 

[oldbearprofessor]

OK, how many interns actually love their NICU time, with no moments of angst! It's really not that bad, but I have a couple of patients now who are frustrating; including the one with PPHN-a very interesting disease, which generally doesn't mean good things if you are a patient. And another who should be comfort care but whose parents aren't ready to let her go. That said, it is absolutely amazing how many of the premature, and especially very small babies have good outcomes-I expected it to be much worse. One of my most stable patients weighs under a kilo. It took me 2 days before I'd do anything but listen to his heart and lungs!

I promise I'll stop hijacking-just had to vent! 😉

I see a budding neonatologist here! They always start by saying "it's really not that bad"! Next thing you know, they're "hooked" on babies. 😀

Actually PPHN is often one of the more rewarding diseases to treat because the babies usually (if it isn't due to diaphragmatic hernia or asphyxia) recover and do well long-term. Of course, night call taking care of them can be tough! Babies with severe congenital defects are much more difficult as often there isn't anything that can be done for their primary problem. And what intern doesn't have angst, wherever they are?? I think that interns should only be in level 3 NICU's for a short time if at all (better as a PL-2 rotation) - more time to do well baby and level 2 care as an intern.

Back to the original topic...General pediatricians do a lot of nutrition counseling - both related to babies and breast milk/formula issues, and more recently due to the obesity problem. Future pedis would be well advised to take a college nutrition course if they can (or, of course, take my nutrition elective when in their 3rd or 4th yr of med school, but that was a completely different thread). 😀

Regards

"oldbear professor"