Page created on February 24, 2022. Not updated since.
Introduction
Some countries, like Hungary, have dedicated primary care physicians (PCPs) or general practitioners (GPs) for children. These primary care paediatricians perform the same tasks as primary care physicians, but only for children. In countries who don’t have primary care paediatricians, the primary care physicians or specialised nurses perform this task. I’ll use the abbreviation PCP to refer to both primary care paediatricians and primary care physicians in this topic.
The main duties of PCPs are to administer immunisations (vaccinations), review development, promote health, and evaluate and treat mild paediatric illness which don’t require specialists. If the child requires a paediatric specialist, they will refer them to one. However, they will also care for children with serious, chronic disorders like cystic fibrosis, cerebral palsy, and mental health problems.
Many disorders are preventable or better managed if identified early (see also next topic).
Regular consultations
Children, especially in the first years of age, should undergo regular check-ups with a specialised nurse and/or PCP. These routine consultations aim to identify and prevent risk factors for physical and mental health problems. In Norway, it’s recommended to have 14 consultations with a nurse and/or PCP in the first 5 years, and the physician is involved in four of them:
- 6 weeks
- 6 months
- 1 year
- 2 years
.. while the rest are carried out by the specialised nurse alone. The first visit by the nurse is ideally a home visit, to identify possible negative health factors.
Examples of parameters to be evaluated during consultations are:
- General condition of child (well-kept/neglected/abused)
- Growth (weight, height, head circumference)
- Hearing
- Vision
- Psychomotor development (walking, hand function, attention, social contact, language)
- A general physical examination (oral cavity, heart, lungs, abdomen, genitalia)
During these check-ups, the parents’ questions or concerns are addressed, and the relationship between the child and the family is assessed. Healthy behaviours are promoted, like breastfeeding, a tobacco-free home environment, exercise, food habits, dental hygiene, proper use of screens and devices, etc. Risk factors for cardiovascular disease should also be assessed (see topic 48).
Following the child’s beginning of school life at around the age of 6, nurses or physicians at the school are usually involved in continued primary care of the schoolchildren.