Who do you refer to?
Started by Merely
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I have a different question, if you have someone who is younger than 18 years old, why would you refer them to an adult surgeon for any surgery if you had the option to send them to a pediatric one (unless that adult surgeon has a unique surgical niche that the pediatric one doesn't)? Heck, pediatric CT surgeons do heart surgery on 35 year old TOFs repairs, but you can bet no adult CT surgeons do TOFs repairs on 35 day olds.
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Is a 16 year old so different from an 18 year old for the more common procedures that you wouldn't trust an adult surgeon to take out their appendix? The vast majority of us don't have easy access to pediatric surgeons so if the adult folks are willing/able to do it, I'm ok with it.
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For us locally, 14+ goes to adult, unless it's a peds specific problem.
I have easy access to a pediatric surgeon and give them first right of refusal on anyone 18 and under.
If the scenario was I in a locum tenens position in places without pediatric surgeons, I'd say over 14 it's okay to let the adult surgeons go. If the patient is 16+ then for sure go with the adult surgeons, to the point that I would argue that the transport to a children's hospital was higher risk than keeping them in house.
But if I have pediatric surgeons available, I agree with @DeadCactus, the peds surgeon has right of first refusal.
My favoring a pediatric surgeon in general goes beyond just the surgeon's expertise - even for teenagers, I believe that pediatric hospitals and the ancillary staff (nursing, PT/OT, resp therapists, etc) are far better equipped to meet the needs of the patient than their adult counterparts.
But if I have pediatric surgeons available, I agree with @DeadCactus, the peds surgeon has right of first refusal.
My favoring a pediatric surgeon in general goes beyond just the surgeon's expertise - even for teenagers, I believe that pediatric hospitals and the ancillary staff (nursing, PT/OT, resp therapists, etc) are far better equipped to meet the needs of the patient than their adult counterparts.
Congrats for having the most un-useful answer ever, given that we are the child's doctor and talking about whether we should refer to a pediatric surgeon or an adult surgeon. Parents generally don't make that choice.
