Pediatrician: definition, up to what age to consult him?
The pediatrician is the doctor of children and adolescents. Prevention is one of the main priorities of pediatrics, through early detection of neonatal or genetic diseases, developmental delays, growth delays or puberty, through vaccination, education in food hygiene or prevention mountain view natural medicine. accidents.
What is a pediatrician?
The pediatrician is the doctor specializing in monitoring the development of the child from birth to 18 years and taking charge of all the illnesses of the child. He must check that they are growing and waking up properly mountain view pain , and must vaccinate them. He can also advise parents on education, food hygiene and accident prevention.
What is Pediatrics?
Pediatrics is the medical specialty responsible for all medical follow-up of the child.
Prevention is one of the main priorities of pediatrics, whether it is done:
indirectly by early detection of neonatal or genetic diseases, developmental delays, delays in growth or
or directly by vaccination, education in food hygiene or accident prevention.
"Neonatology, which specializes in newborns and premature children, is one of the most important branches of pediatrics. In addition, some pediatricians specialize in more specific areas such as cardiology, neurology or surgery... All adult specialties are represented in pediatrics, there are, for example, gyneco-pediatricians or rheumato-pediatricians", explains Doctor Aude Mariani-Ecochard, pediatrician at the Clinique St Jean in Montpellier.
What does a pediatrician treat?
"Neonatology, which specializes in newborns and premature children, is one of the most important branches of pediatrics.
monitoring of height and weight growth (changes in weight and height as a function of age) and puberty development,
monitoring of psychomotor development, language,
affective monitoring of the child
, early detection of anomalies or deficiencies,
practice or verification of vaccinations,
frequent childhood diseases and their treatment (chickenpox, nasopharyngitis, angina, roseola, diarrhea, bronchiolitis, urinary or pulmonary infection, etc.),
advice to parents: support for breastfeeding, food diversification, nutrition, prevention of domestic accidents, help with parenthood.
When to consult a pediatrician?
The child can consult the pediatrician:
In scheduled consultation with his usual pediatrician (treating pediatrician) for the monitoring of his growth and his psychomotor development. In this case, the medical visits are adapted to the age of the child and his clinical condition (consultations will, for example, be more frequent for a premature or asthmatic child). For example, consultations may take place every month until 6 months, then every 3 months until 1 year, then every 6 months until 4 years, then every year,
In emergency consultation for management of an intercurrent illness, fever or any other problem justifying rapid medical advice. "In the emergency room and in hospitalization, the pediatrician takes care of more serious conditions such as severe infectious problems (acute gastroenteritis with dehydration, severe bronchiolitis, meningitis, etc.), trauma or even inflammatory diseases", adds Dr. Mariani-Ecochard.
In scheduled consultation with a specialized pediatrician, for a one-off opinion or specialized follow-up: monitoring of asthma by a pneumopediatrician, or management of delayed puberty by an endocrino-pediatrician
Pediatrician: from what age to what age?
But there are some exceptions:
In the emergency room or in hospital, the child will be referred to a pediatric service if he is less than 15 years and 3 months old (this varies according to the structures and pathologies in question).
When the child has been followed for several years for a chronic disease by a pediatric team, he can be followed until he is 18 or 20 years old before being referred to adult doctors
Children with mental disabilities are sometimes treated by pediatricians even after the age of 20
"Because there aren't enough pediatricians in town, children are frequently seen by general practitioners. It is nevertheless advisable to schedule an annual consultation with a pediatrician for follow-up specific pediatric medicine (psychomotor development, growth, puberty...)", recalls the doctor.
Pediatrician: what are the mandatory visits?
Children are subject to 20 compulsory medical examinations until they turn 18: 14 in the first three years, 3 from 4th to 6th year and 3 from 7th to 18th year.
Examinations carried out within eight days of birth, during the 9th month and during the 24th month give rise to the establishment of a health certificate to be sent to the doctor of the PMI (Protection Maternelle Infantile). The sending of these certificates has 2 objectives:
On the individual level, to offer families possible help according to their needs, for example for twin pregnancies, premature children, etc.
On the public health level, anonymously, to ensure a epidemiological monitoring of perinatal health data.
What happens during a consultation ?
Scheduled visits focus on growth parameters (weight, height and body mass index), psychomotor development and monitoring of vaccinations.
At a more advanced age, the examinations are supplemented by the study ofhearing, vision, then the monitoring of puberty development.
When the reason for consultation is an illness, the pediatrician concentrates on the information collected from the parents, the clinical signs and the systematic complete examination.
The treatment prescribed depends on the disease; in the event of a serious and specific illness, the general pediatrician can refer the child to a specialist or an emergency department for appropriate care.
Preparing for a visit to the pediatrician
For many children, a visit to the pediatrician can be anxiety-provoking. To prepare for it, there are solutions:
Choose the right time for the meeting, avoiding nap time, bottle time or the end of the day.
Talk about the doctor, explaining that his role is to treat him.
Explain to the child in detail how the consultation will take place. Tell him in particular that we will undress him while respecting his modesty, that you will stay with him
Prepare the bag for his child with, depending on age, nappies, hygiene products, the health record and his comforter. To make him wait in the waiting room, it is also recommended to slip a few toys or books into the bag.
Avoid sentences such as "if you are not good, the doctor will give you an injection", because the child risks interpreting the vaccine as a punishment.
Manage your anxieties yourself in the face of the medical consultation: the pediatrician is there to accompany you and support you, and not to judge you,
Do not forget to take the child's health record.
Price and reimbursement
The price of a consultation varies according to age, the time of the appointment, and the type of pediatrician consulted (doctor practicing or not an excess fee). Reimbursement will depend on whether or not there is an excess, depending on your health insurance
If the doctor consults without exceeding the fee (pediatrician in Sector 1), the consultation will be fully reimbursed and will amount to
• 46 euros between 0 and 1 month
• 32 euros between 1 month and 2 years old
• 30 euros between 2 and 6 years old
• 28 euros between 6 and 16 years old
• 46 euros during the 3 examinations giving rise to a health certificate (8 days, 9 months and 2 years)
"Increases are to be added if the consultation takes place after 8 p.m. (+35 euros) or on a public holiday (+19 euros). These increases are reimbursed", specifies the pediatrician. In addition, there will also be a supplement (also reimbursed) in the event of a specific vision or hearing test. If the pediatrician is in sector 2, he will invoice a variable fee overrun depending on the doctors. Reimbursement for this excess depends on your health insurance. As for adults, the pediatrician can be registered with the CPAM as your child's "attending doctor".
Note: the PMI (Protection Maternelle Infantile) are present in each city, and they offer free monitoring of children from 0 to 6 years old.
What studies to become a pediatrician?
To become a pediatrician, only one solution: the faculty of medicine. Places being counted in the first year of medicine, future pediatricians must work hard to reach the top of the ranking and be admitted to medicine.
The initial training is common to all medical students, with morning internships in hospitals from the 3rd year and courses at the faculty in the afternoon.
Once the first 6 years have been completed, the medical student will be confronted with the examination ranking him at the national level. This ranking will determine his chosen specialty and his city of practice. There are then 4 years of internship in a hospital environment in various pediatric departments."Finally, a student must defend a thesis in medicine and acquire a specialised diploma in order to work as a paediatrician and use the title of doctor."studies in pediatrics", adds Dr Aude Mariani-Ecochard.
Where to find a pediatrician?
The pediatrician officiates:
• In the hospital, in the pediatric wards and in the emergency room.
• As a liberal, in a town office.
• In maternities.
• In SMIs.
• In nurseries, in schools.
• In specialized institutions (for example, with young people with disabilities)
