Wednesday, March 14, 2012

I suppose he found something wrong - reflux ignored

I have just seen a family with a previously ill child.  But their GP is not happy with me or my diagnosis.

After coming to see me in the Children's Clinic (and being successfully treated), their GP said to the mum: "I suppose now there is something wrong with her - if you had left her with me for the day, I would let her cry it out."  The implication was that the baby was being naughty, that the mother was making up the illness ("it's all in your head") and that I was fabricating the diagnosis and treatment.

Oh dear!

This baby girl had been screaming at night, appearing to be in pain.  She would often vomit and spill up old milk. She was distressed with gastric reflux (GORD).  She responded well to acid suppression medications (omeprazole 10 mg a day) and is now happy at last and sleeping again.

Yes, she did have a real illness.  So I ask you: "Is it a crime for me to make a diagnosis that the GP has not made?"

In my opinion, as a paediatric specialist and gastroenterologist, if a child is in pain, then it is likely that something is wrong. If I can diagnose the child's problem and help her get well, surely this is a good thing to have done.  So why is the GP so critical of me, of mum and of the baby?

The most common illnesses in children, after viral diseases, is food allergy, food intolerance and gastric reflux disease. Unfortunately, GPs have been encouraged not to treat these diseases, but rather to regard these symptoms as if they are part of 'normal child development'.  By taking this viewpoint, they can then justify saying "it is something that you will just have to put up with - or grow out of" and they can then place the blame for the child's behaviour on the parent's incompetent child management skills (or lack of them).

Blame the child, blame the parents, and then blame the paediatrican for making a non-existant diagnosis.

Oh dear!

I see my role as an advocate for the baby and family.  My job is to help solve the child's problem - not to ignore their pain.

Dr Rodney Ford

No comments:

Post a Comment