When is a trip to the pediatrician the right prescription?
Is it viral or bacterial? Common illnesses that stem from a virus get better on their own, although they may make kids feel miserable. But illnesses caused by bacteria generally require a visit with the doctor and a course of antibiotics.
And it's difficult for parents to know the difference without seeing the doctor.
Doctors face huge difficulty coming up with clear-cut guidelines to help parents make that decision.
Naturally, the parent's first and most important resource is the family's health-care provider. But trying to decide what warrants medical attention and when is often a difficult task.
"If a parent is truly worried, they need to at least call the doctor," said Bonnie Midget, spokeswoman for Primary Children's Medical Center. "But the more education the parent has, the more information they have access to, the better decision they can make."
According to the Mayo Clinic, the top five infectious illnesses that keep children out of school are colds, gastroenteritis, ear infections, pink eye and sore throats.
Most medical clinics have staff available to take calls and answer questions related to these illnesses and other common complaints. But some have made information available online, as well.
KidsHealth, which can be accessed at www.primarychildrens.org, is a comprehensive site that offers links to dozens of topics from the common cold and ear infection to emotional and behavioral issues.
Each section includes information about an illness, what causes it and how long it might last. The sections also include details about what a parent might expect for diagnosis and treatment and specific guidelines about when to call the doctor.
For example, for a child with a sore throat, the site says: Not all sore throats are strep throats. Most episodes of sore throat — which can be accompanied by a runny nose, cough, hoarseness and red eyes — are caused by viruses and usually clear up on their own without medical treatment. A child with strep throat will start to develop other symptoms within about three days, such as:
• red and white patches in the throat
• difficulty swallowing
• tender or swollen glands (lymph nodes) in the neck
• red and enlarged tonsils
• headache
• lower stomach pain
• fever
• general discomfort, uneasiness, or ill feeling
• loss of appetite and nausea
• rash
Midget said this information and more is provided in partnership with the Nemours Foundation. Physicians at Primary Children's are on the committee that regularly updates the site and makes sure it contains the most current information.
"It takes the place of the initial triage," she said, "but it certainly doesn't take the place of a health-care provider."
Another example of a local, Web-based resource is that offered by Utah Valley Pediatrics, LC at www.uvpediatrics.com. Administrator Kevin Moffitt said the Web site was put together with two purposes.
"Our doctors were concerned that there are parents who are not calling us and they should be," he said.
In addition, the symptom checker offered on this Web site provides a sense of relief for many parents by providing answers to some common concerns.
The information provided there is based on telephone protocols written by Dr. Barton Schmitt, a pediatrician with The Children's Hospital in Colorado. Moffitt said this is the same information used by nurses who are taking questions over the phone.
At Holladay Pediatrics, Dr. Mark Briesacher said he has often recommended www.kidscareonline.com — a site that reports cold symptoms as the No. 1 reason for office and emergency department visits — as a reliable source for parents. However, he also takes every opportunity to educate parents in the clinic.
"The way we look at children's health care is it being a partnership between everyone in our clinic and the family," he said. "I am relying on (the parent) and (the parent) is relying on me, and the end result is the best possible care for the patient."
Clinically speaking, Briesacher agreed that there might be times when doctors see patients who didn't necessarily need to come to the doctor. But, he said, you can never make decisions based on symptoms alone.
Instead, every visit becomes an opportunity for teaching. Briesacher explained that very often, when people call to request an appointment, they are reacting based upon their personal experience. So a parent might ask to see the doctor not just because a child is vomiting, but because they know someone whose child was diagnosed with a serious illness like leukemia — and that child had only been vomiting.
In the clinic, Briesacher is able to talk to the parent, explain what the child is experiencing and teach the caregiver what to look for, creating a new personal experience and expanding on the idea of a partnership between doctor and parent.
The overall goal of such Web sites is to enhance the knowledge and education of parents.
"It gives really good, concrete advice," Midget said of KidsHealth.
But, while the information provided can be very helpful, it does not replace a doctor's examination.
