Pediatric Specialists
Your pediatrician will be able to handle almost all of your new baby's healthcare needs. The average pediatrician is well trained to help with all of the problems new parents face, from advice about day-to-day basics, such as feeding and sleep issues, to caring for your baby when he is sick. (See Chapter 15 for more information on what to expect during visits to your pediatrician's office.)
Some pediatric specialists train for more than fourteen years to learn to provide their specialty care. A pediatric plastic surgeon, for example, in addition to four years of college and medical school, three years of a surgery residency, and three years of plastic surgery training, undergoes additional training in pediatric plastic surgery.
However, there may be times when your baby needs more care than your pediatrician can provide. Maybe he is not gaining weight well, is having seizures, or is not meeting his developmental milestones, and you and your pediatrician need some help figuring out what is going on. Or your baby may have a common illness, like reflux, allergies, or asthma, but isn't responding to traditional treatments. Any of these situations might lead a new parent to seek an evaluation by a specialist.
Types of Specialists
There are many different specialists who care for kids. Especially for older children, you might end up seeing a specialist who cares for both kids and adults, or you could see a pediatric specialist who only cares for children.
Many pediatric specialists are also pediatricians. After completing their general pediatric training, they then go on to do a three-year fellowship and get their specialist training. These types of specialists include, among others, pediatric cardiologists, endocrinologists, gastroenterologists, hematologists, and pulmonologists. There also are pediatric specialists in genetics, nephrology, neurology, emergency medicine, and infectious disease. There is even a type of doctor, a pediatric hospitalist, who specializes in taking care of kids, but only when they are admitted to the hospital.
Other types of pediatric specialists, including most of the ones who do surgery, are not usually pediatricians. They complete additional pediatric specialist training, though. These include pediatric surgeons, neurosurgeons, ophthalmologists, and pediatric orthopedic surgeons.
You should usually ask your pediatrician before going to a specialist, even if you don't need a referral. That way, you can be sure to see a doctor that your pediatrician knows and trusts.
And then there are specialists who see and care for kids, but don't necessarily have any advanced pediatric training and are not board certified in a pediatric specialty. However, that doesn't mean that they shouldn't see your child, because they usually have some training in managing pediatric problems. Specialists who see both kids and adults might include general surgeons, allergists, and dermatologists. Your pediatrician can help you choose the specialist who would be best to see your child when and if it becomes necessary.
There are many other health-care professionals who are not doctors but still can help take care of your child's health-care needs. These include speech, occupational, and physical therapists to manage and treat developmental delays, and lactation consultants to help with breastfeeding problems.
Second Opinions
One of the most common reasons to see a specialist is because your pediatrician thinks that it is necessary. Another reason, though, is simply because you want a second opinion. You might disagree with your pediatrician, either because she is being too aggressive or not aggressive enough, or you may just feel more comfortable and better reassured with a specialist's opinion. Don't be afraid to ask for a second opinion if you want one.
Although getting a second opinion from a specialist should be an easy process, there are a few potential roadblocks that you might encounter. One common problem is that there may not be a specialist available in your area or there might be a long waiting list to see the doctors who are nearby. In either situation, you might ask your pediatrician to call a specialist to get further advice about what to do for your child.
Another problem might be that your pediatrician simply refuses to refer you to a specialist. You shouldn't have to beg for a referral, and if your pediatrician can't convince you that it isn't necessary, then you might want to go to a different pediatrician.
Lastly, your insurance company might refuse to authorize the referral. A letter of medical necessity from your pediatrician should be enough to override this refusal, though you may have to ask about an appeal process to get the referral approved.
