Does my child really need to go to the doctor when they aren't sick?
Updated: Nov 29, 2021
Why go to the doctor regularly?
During the first two years of life you find yourself frequently visiting your child's primary care provider. These frequent visits often coincide with the regular vaccination schedule and monitoring of developmental milestones. After this time the frequency of visits tends to wax and wane. We often see kids only when a physical form is required for school, or when vaccinations are required. Typically this is again at age four to six, again at eleven and then typically around age sixteen. But what about those in between ages? While you may think to yourself, "my child is healthy, so why would I need to go to the doctor?", I am here to tell you the importance of regular well-child checks or annual physical exams. Most providers recommend at least yearly check ups for all children. So what is it that we cover in these visits?
Storing up concerns
I like to start these visits off with any concerns that parents or patients may have. This however can be challenging if you are storing up a list of concerns for this yearly visit. I definitely welcome concerns and even recommend writing them down so you don’t forget them, but if this list is long it can leave little time to give each concern it due diligence and also makes it so that we often run out of time to talk about the “normal” things at the well visit, which I will outline in this episode. In general, I recommend if you have concerns that are specific you schedule a separate appointment. Otherwise, if they are not large concerns or are related to everyday things then this is a good time to chat about them.
I usually use the beginning of the appointment to touch base on any specialists that your child is seeing. It is a great way to remind you of any upcoming appointments or follow ups that need to be scheduled. I also use this time to discuss any therapies that your child is in and make sure that we are making progress and evaluate if new referrals need to be sent.
The meat and potatoes of the well child visit
Well child visits are a great way to check in on the everyday things of life such as diet, sleep, peeing, and pooping. At the very least, it is a nice way to have someone else lecture your child on eating their fruits and vegetables, so that mom or dad is not the only one “nagging” on them about these things. Same goes for sleep habits. It’s always nice to have someone else tell your child that they need to go to bed earlier, shut their tv or phone off or limit their screen time. During this time we also tend to uncover and discuss important sleep problems or picky eating that may need more attention.
Bowel habits is another favorite topic that we address at these visits. I feel as though I spend half of my days talking about poop because it is so important. Not every parent is frequently checking in on their childs bowel patterns, especially as they get older, so you may find out at their well visit that they actually are constipated. I think it is so important that we teach our children that it is normal to talk about these things and that they need to be in check with their bodies.
Preventative Health
Not only do we talk about those everyday things but we talk about things that important for future health. It is a moment for us to discuss the important of getting daily exercise. To acknowledge that we don’t have to look at exercise as just running on a treadmill or lifting weights, which is often not appropriate for children, but it is finding something that they enjoy doing that moves their body for at least 30 minutes per day. I like to challenge children to pick an activity that they like and that is realistic for them to accomplish. If we can talk about this in a positive way, we can set the tone for getting daily activity as they get older. We discuss seeing the dentist and brushing their teeth. We talk about eye health and hearing and the importance of regular eye examinations.
The Exam
One thing that you don’t necessarily think about monitoring as kids get older is their height and weight. We want to monitor children’s growth on a yearly basis after that initial two years of life so that we can make sure that they are following their “curve”. Growth curves or growth charts let us know that they are growing at the appropriate velocity for height and weight and shed light on any concerns or workups that we may need to do. Yes, parents can tell that their child is growing, but it is not always easy to make sure that they are growing at the appropriate rate for their age. The physical exam includes an overview of each of the body systems including eyes, ears, heart, lungs and so on. It is important to get a yearly baseline so that if something abnormal is found we know how long this has been a concern and if it has been present in the past. We are also are monitoring their pubertal development and making sure that it is not occurring to early or that they are not delayed in pubertal development. This is a way to discuss some important topics that are often times embarrassing or taboo for kids in a way that is natural and not made out to be a big deal.
The teenagers
Teens are a group that are especially lacking in well child exams and are arguably one of the most important age brackets to have regular exams and education regarding their bodies, health and safety topics. These visits can be used as a way to educate them on their health. They need to learn to view their health as an important aspect of their life and to take control of it. The biggest points to discuss at these teen checkups are their mental health, sexual health and substance use. Often times parents have a difficult time discussing these things so it is a great time to bring it up. We screen all of our teenagers for depression and assess their overall mental health. They need to build up trust with someone, so that if and when something comes up in the future they have a familiar face outside of their family to talk to about it to. Some kids are very open with their parents, and sometimes they struggle with this. This is also a great time to talk about sexual health and answer any questions that they might have. If we start having them come to the doctor on a regular basis when they are young it will dramatically decrease some of this anxiety and nervousness that comes when coming to the doctor and talking about these things. It will encourage them to be more honest and teach them that it is not a big deal to talk about these things with their trusted medical provider.
Wrap up
Regular visits with your child’s medical provider are important and encouraged for all age groups. Even children who have medical problems or are seeing specialists on a regular basis benefit from maintaining a relationship with their primary provider so that they can develop a baseline understanding of the child and be a resource for anything that comes up. It is also a way to monitor the child’s overall health rather than looking at each problem or body system individually. I would like to challenge you to find out when was the last time your child was seen for a well child visit. If it has been more than a year or past the recommended time for their next visit then schedule the visit! If you don’t have a primary care provider for your child, this is the time to do it. It is so much better to establish a relationship with a provider before a problem or concern with your child arises so that they know you and your child at their baseline. This will also make going to the doctor a lot less scary so that they know what to expect and they can know and trust the person that they are going in to see rather than it being this whole unknown situation.
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