Plan ‘ahead’ for child’s doc visits, say experts

‘Safety net’ clinics benefit uneven

NEW YORK, July 5, (RTRS): Parents can make the most of their time at their child’s routine pediatrician visits by preparing for each appointment, according to a new resource published in JAMA Pediatrics.

The American Academy of Pediatrics recommends that children see a pediatrician regularly and often during their first three years of life.

“Parents’ time is becoming more and more precious, and these appointments are so frequent, that we want to help people make the most of that time,” said Dr Maheen Quadri of Ann and Robert H. Lurie Children’s Hospital of Chicago, who co-wrote the one-page primer intended for parents and caregivers.

“One of the most important things we do during these visits is give vaccines,” Quadri said in a phone interview. “Before appointments, it’s important to know what’s up-to-date.”

The freely accessible patient page emphasizes the best ways for parents to prepare children and their medical files before meeting with doctors.

“It’s also really valuable to have that one-on-one time with a doctor, especially when we have so many resources online with different medical advice,” she said. “Having that connection with a person who has expertise can be a source of support as you go through the new experience of parenting.”

Quadri and co-author Megan Moreno of the University of Wisconsin School of Medicine and Public Health in Madison first recommend knowing your child’s history and family’s history to ensure that medical records are accurate and up-to-date. Don’t forget to transfer them if seeing a new clinician, and consider taking a folder with your child’s records to appointments.

The doctor will ask questions about your child’s health, your family’s health and your child’s development at every visit. It helps to be familiar with developmental milestones, such as crawling, walking, and different phases of talking. The doctor may ask you to fill out development questionnaires to assess how your child’s growth is progressing, so pay attention to these milestones between visits.

“Many parents don’t realize that yearly health supervision or ‘check-up’ visits are recommended for children age 3 (years) and up as well,” said Dr Jennifer Shu of Children’s Medical Group in Atlanta, Georgia, who is also medical editor of HealthyChildren.org.

“When children are younger and making frequent visits to the pediatrician for routine immunizations and the expected toddler illnesses, going to the doctor is topof-mind,” she told Reuters Health by email. “Once kids start elementary school, check-ups can fall out of habit.”

The patient resource also recommends bringing a list of questions about health and development topics to visits. For questions about movements or behaviors, for instance, consider bringing a picture or video. For children who take medicine, including inhalers, it helps to bring the drugs to the visit to confirm current doses and ask any questions.

Smoking:

Health clinics where low-income people in the US obtain medical care don’t always offer help with quitting smoking — and availability of that assistance may vary by patients’ ethnicity and insurance, a recent study suggests.

So-called safety net clinics exist to reduce barriers to healthcare. Patients at these clinics have higher-than-average rates of smoking, so it’s particularly important to address these disparities, said Dr Steffani Bailey, a family medicine researcher at Oregon Health & Science University School of Medicine in Portland.

“We need to ensure that all patients, particularly in these settings, are getting access to the assistance that they need to help them to quit smoking,” she said in an email.

Bailey and her team examined electronic health record data from 136,314 smokers at 143 clinics in 12 states between 2014 and 2016. The researchers analyzed the type of smoking cessation assistance these patients received — whether it was no assistance, counseling only, medication only or counseling and medication together.

They also looked at whether age, gender, race, income level, insurance status and the presence of medical and psychiatric conditions influenced who received cessation help.

The odds of getting both counseling and medication — which is considered best practice — were lower among patients of all ethnicities combined than they were among non-Hispanic whites, the researchers found.