When my eldest child was born, as concerned new parents, my husband and I dutifully took him to the paediatrician at the hospital every month for his vaccinations and checkups until he was about six months old. That is, until a friend enlightened me that the neighbourhood paediatrician should serve just as well.
A little slow in getting the concept, I had a light-bulb moment nonetheless, and thereafter, a paediatrician near my home became his regular consultant until my son reached school-going age. After that, we turned to our family doctor for all his medical needs.
By the time our third child came along, we didn’t even bother going to a paediatrician and instead, consulted the general practitioner (GP) from the start, even for his first-month vaccination.
In truth, the biggest mitigating factor was the cost involved as paediatricians generally charge a little more than GPs. It never occurred to me whether making the transition from a paediatrician to a family doctor might affect my children’s healthcare.
Recently, however, when a friend asked whether I could recommend a paediatrician for her toddler who was unwell, she was taken aback when I suggested she see the local GP.
“Are you sure they know how to handle kids?” she asked.
According to consultant paediatrician Dr Ling Shih Gang, the majority of problems can be handled by a GP.
“Parents just want the reassurance as they feel more comfortable with a paediatrician (who is deemed a specialist in children’s health) and as such, are willing to pay more,” he says.
“In Malaysia, we are seen as the first line of defence for children. Paediatricians charge slightly more than GPs, yes, but we are still very reasonable. Parents, especially in the urban areas, prefer to consult a paediatrician for children’s vaccines and minor ailments,” adds the Klang Valley-based Dr Ling, who, in addition to operating a private practice, is also a consultant at a private hospital in Petaling Jaya, Selangor.
Consultancy charges, notes Dr Ling, can be as low as RM30 to RM80 (without medicine), which are still affordable for the majority in Malaysia.
Generally, common complaints such as coughs and colds, disturbed sleep patterns and nutritional needs are handled by paediatricians on a daily basis, with the exception of more chronic illnesses such as diabetes and congenital heart diseases, which are referred to hospitals for attention.
Normally, a visit to the paediatrician would include a complete physical examination of the infant’s growth and development, and the child’s height, weight and other important information would be recorded.
Other than an obvious difference in body size, paediatrics differs from adult medicine in various aspects.
Congenital defects, genetic variance and developmental issues are of greater concern, and treating a child can be quite different from an adult.
Another consultant paediatrician, who runs a private practice in Petaling Jaya, confirms that there is no official cut-off age set by the Malaysian Paediatric Association but most doctors will see child patients aged up to 12 years.
Parents naturally taper off the visits when their children get older. In the United States, this is officially extended up to 18 years.
“That being said, all paediatricians have a handful of adolescent patients who have grown up with them. For most children, general growth and development monitoring carry on until the child is two-and-a-half years old. After that, the rest is optional,” says the paediatrician who wants to be known only as Dr M.F.
“We look into behavioural or growth-related problems, as well as all sorts of infections, tract illnesses, skin problems, gastrointestinal infections and chronic problems. A paediatrician is trained to see the full spectrum and treat the whole patient. We try to treat according to diagnosis rather than just giving symptomatic treatment. And we give evidence-based treatment that won’t harm the child,” she assures.
“I do see children with developmental changes or concerns, but usually parents don’t consult paediatricians on puberty matters. If parents ask for the cervical cancer vaccination (HPV vaccine), it’s available (most paediatricians can administer the vaccine),” she adds.
Certain GPs who are not specialised in handling children may sometimes dispense unnecessary extra medication to treat a problem.
“Some GPs may over-treat. Most paediatricians don’t carry out unnecessary treatments. We prescribe age-appropriate medication to children, bearing in mind their weight and age,” says Dr Ling.
He adds that the younger batch of GPs these days may not have the experience to handle children (since many parents go straight to paediatricians). “A number of places now offer 24-hour clinics and quite often, it’s a locum, so it may be rather hard to get a GP who is familiar with your case.
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