Bypassing an appointment to monitor an infectious disease outbreak is a new trend

Like most people, pediatricians are so short on time that they still miss a lot of diseases that require treatment that’s not available in their communities or that they are on the cusp of….

Bypassing an appointment to monitor an infectious disease outbreak is a new trend

Like most people, pediatricians are so short on time that they still miss a lot of diseases that require treatment that’s not available in their communities or that they are on the cusp of. That’s why one-half of all pediatricians just skipped an exam this week to attend a meeting to discuss major infectious disease outbreaks.

The National Pediatric Infectious Disease Partnership said these meetings provide an opportunity to discuss how to better manage medicine across the pediatric spectrum.

“If we really want to contain infectious disease, we need to look at the whole child and try to build communities with interventions that work for all children,” said Dr. Claudia Fuller, a lead author of the new report.

Tackling infectious disease in addition to catching other illnesses – particularly in very young children – is tough. Pediatricians who missed an exam this week are among physicians that usually get that call after 48 hours to see if it’s safe to treat. Some doctors do not have the time to complete the evaluation and treatment for one set of illnesses and worry that they won’t see other children in need.

The report, released Wednesday by the National Pediatric Infectious Disease Partnership, a collaboration between the US Centers for Disease Control and Prevention and the American Academy of Pediatrics, sheds new light on how this devastating disease management is best done.

The researchers broke up the World Health Organization’s 42 separate categories into four categories: emergencies, emergencies with higher priority, preventable-disease cases and ongoing childhood diseases. It is time-consuming and resource-intensive to treat every pediatric emergency.

“The most common emergencies involve using antimicrobial medications to treat measles, rubella, tuberculosis, influenza, some rarest disease categories and malaria-related diseases in Africa,” the report says. “Sometimes, we do these cases in certain parts of the country where there is no access to medicine.”

Eighty-one percent of infant and 19 percent of pediatric subspecialists report missing an appointment or unnecessary but timely cases during the past 12 months. In most circumstances, these children miss an appointment for a day or more. For example, the report says that when one out of seven families chooses to skip a doctor’s appointment, it will cost the doctor $45.

One of the authors of the report pointed out that in many instances, no one has the resources to identify an emergency.

“Preventable medical emergencies, or cases where the child doesn’t get treated and dies, have gone undiagnosed and untreated because no one has time,” Fuller said. “Only one-third of caregivers record emergency cases, a critical step.”

The report is accompanied by practical recommendations. For instance, the report includes a recommendation that pediatricians contact relatives and care providers to bring up cases of asthma or pneumonia or substance abuse and substance misuse, that they routinely check the national case registry and the diseases known to be contributing to infant deaths (most children who die from sudden infant death syndrome are expected to have hidden exposure).

Treating a pediatric disease such as measles, rubella or pertussis requires a lot of work and emotional energy. Many patients rely on emergency physicians for interventions they couldn’t get at home, including immune globulin and antibiotic treatment.

The report shows that many pediatricians are recognizing pediatric emergency medicine as a priority and making a concerted effort to see every child who needs an emergency. That’s important in an age where so many children have smartphones.

The recommendations by the American Academy of Pediatrics to the US Department of Health and Human Services provide more detail on how much they would like them implemented.

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