Pediatricians Are Different from Other Doctors
by Herschel R. Lessin, MD

I have noticed that pediatricians are different from other doctors. Other physicians are usually found dressed either in starched white lab coats or conservative dark suits, discussing serious health issues with their adult patients. Pediatricians also discuss serious health issues, but more often than not we are found dressed in Mickey Mouse ties sitting on the floor playing pat-a-cake with a toddler.

You see, children are not simply little adults. The most common mistake people make when they think about pediatrics and pediatricians is to assume that it's mostly like adult medicine, but made smaller to fit children. Unfortunately, the health needs of children are neither smaller nor the same as those of adults. Instead, their needs require a completely different approach, one that goes way beyond efforts to help children get over their fear and anxiety, way beyond playing and often acting silly with them. The fact is that children are not little adults.

They may have similar problems such as cancer, substance abuse, heart disease, and high cholesterol, but a pediatrician's approach to these and other problems must be vastly different from the approach any medical doctor takes with an adult. The way a problem shows up is different in children. Its progression and symptoms are different in children, and its outcome can be very different in children. To make matters even more complicated, all of the above factors can change dramatically with a small difference in age. The course and prognosis of an illness can be dramatically different depending on whether the child is a one-year-old or a five-year-old. A similar difference does not exist between, say, a fifty-one- and a fifty-five-year-old.

The difference starts in our approach to the patient. Most kids learn at an early age that the doctor's office is a place where various sneaky and nasty things will happen to them. It doesn't matter that it's for their own good. No one likes needles, no matter how much good they do. A pediatrician cannot easily appreciate subtle differences in the sound of the heart and lungs when a child is screaming bloody murder into his stethoscope. So a good pediatrician often has to be like a stage performer. Even if he's having a lousy day, when he goes to examine the child, it's "Showtime!" Suddenly a grown adult with more than twenty years of education under his or her belt is known to emit unusual gurgling, cooing and squealing noises. His face undergoes astounding contortions. Games that most other adults have not thought of since childhood come pouring forth in a torrent of activity. The tools of his trade are adorned with stickers. Unusual critters of all varieties may reside in the pocket of his coat or his desk drawers. If all this activity has the desired result, the child will be smiling, happy and cooperative, and perhaps even remember having a good time, despite the sharp implements.

Pediatricians seem to have more fun. We are very lucky people. Because of our job, we have a license to act silly, to act like children. For those of us who use this license happily, it is a wonderful reliever of stress. For no matter how bad the day has been, no matter what terrible illnesses or problems you've seen, you can always retreat and play with the children. And over the years, as the children grow up, you are recognized when you're out shopping or at the mall. All those kids who were once terrified in your office now run up calling out: "Look, there's Dr. Lessin! Hello, Dr. Lessin!" All the crying and discomfort is forgotten. You forget all the middle-of-the-night calls, long hours, and much of the aggravation. What a nice feeling!

Because of all of these factors, doctors who care for children need to be trained in a specialized approach--in the care of children. Knowing how to care for adults is not the same. Even though they are not often viewed as such, pediatricians are specialists, specialists in children.

Dr. Herschel R. Lessin has been caring for the children of the Hudson Valley for 20 years. He is the Medical Director of The Children's Medical Group, PLLC with offices in Rhinebeck, Poughkeepsie, Modena, Hopewell Junction, Fishkill, and Newburgh. Visit him on the web at www.hvmedweb.com/CMG.