Speciality Care

The specialist or consultant may play a major role in the management of children with chronic illness.The specialist may be the first to consider the diagnosis or may actually confirm the PCP’s suspicions.Depending on the condition, the specialist may be pivotal in defining the treatment plan and will be the one to provide follow-up for the problems that are specific to be condition.The degree of involvement will vary with the diagnosis and the organ systems involved.Many children receive the majority of their medical care from specialists and consultans.The ideal approach to management is that there is continuity provided by a primary care physician who may be a pediatrician, a family practitioner, or a generalist.On occasions the specialist will function as a primary caretaker.This has merit if the approach of the consultant is able to be broad-based and when the condition has a dominant system involvement in which the consultant is expert.
Subspecialist may have limited knowledge of so-called normal pediatric care which implies awareness of appropriate growth and development and of how to achieve this. They also need to be able to involve the various consultans that are indicated.The devlopment of specialty services has also led to some problems.There is increased difficulty to access specialty care and care tends to be fragmented.Priority approval is often necessary before services are paid for and, in many situations that are deemed not an emergency, there may be delay before treatment is initiated.This can be frustrating to the family as well as to the caregiver.