Telemedicine appointments with a pediatrician are one option available to parents who do not want to delay seeking care from their doctor. Carolina Pombar, MD, a pediatrician the Mount Sinai Doctors Faculty Practice and an Assistant Professor at the Icahn School of Medicine at Mount Sinai, explains what to expect from a telemedicine appointment and some of the benefits.
How is a telemedicine well visit similar to an in-office well visit?
Similar to an in-office visit, during the telemedicine visit, which consists of a face-to-face video conference with your child’s pediatrician, you will have the opportunity to discuss nutrition, development, sleep, parenting, updates on any chronic conditions, and any concerns you have.
How does a telemedicine well visit differ from an in-office visit?
Your child’s pediatrician will not be able to perform a complete exam, however there are many parts of the exam which can be observed on the video conference such as examining your child’s skin or looking for any signs your child may have difficulty breathing. Some of the screening exams which are performed in the office, such as hearing, vision, and blood pressure screens, cannot be done, however your child’s pediatrician will discuss with you the best time to have these checked. If your child is due for immunizations and/or lab work, the doctor will discuss with you the best time to bring your child in for these.
What are some benefits of telemedicine well visits?
During a time that you may not be able to bring your child to the office, telemedicine well visits give you the opportunity to connect with your child’s pediatrician, ask questions, and address concerns you may have. The doctor has the unique opportunity to observe the child in their natural environment, whether it be their permanent or temporary home. Children are often more comfortable in these familiar places and therefore are more playful and vocal. Your pediatrician will be able to do a developmental assessment based on these observations and can guide you about future milestones to look out for. Telemedicine visits let you and your child’s doctor stay up to date with your child’s medical care and allow your family to remain safe at home.
Carolina Pombar, MD
How can you and your child prepare for telemedicine well visits?
Prior to the visit, if you have a scale, you can try to measure your child’s weight without clothes and a diaper on. If you have a measuring tape, you can attempt to measure your child’s height by having them lie down, make a mark or place an object at the top of their head and bottom of their feet and measure the distance in between. Let your child’s doctor know about these measurements during the visit. They will be able to plot them, and you can review your child’s growth curve together.
During the visit, you should have your child available. It is okay if they crawl or walk off to play. Your child’s doctor is happy to observe them play as part of the visit. If possible, have your child wear clothes that can be easily raised up or pulled down in case there is anything you would like the doctor to examine as part of the telemedicine visit.
In which cases may your child’s pediatrician consider treating your child with antibiotics?
Antibiotics are medications which treat bacterial infections. Common bacterial infections that often require antibiotic treatment in children include ear infections, sore throat caused by streptococcal bacteria, certain skin infections, pneumonias, and urinary tract infections.
Why are doctors careful about prescribing antibiotics?
If antibiotics are overused, bacteria can become resistant to them and the medication loses its effectiveness in treating the bacteria. In addition, like all medications, antibiotics can be associated with side effects. Pediatricians have to carefully consider these variables when making the best decision for treatment for your child.
Is an in-office exam necessary to get a prescription for the antibiotics?
Pediatricians use the physical exam as an important diagnostic tool to make decisions about whether or not antibiotics are needed. Some parts of the exam/visit cannot be performed virtually. These include an internal ear exam, listening to the lungs, and swabbing the throat to test for infection. There are some parts of the exam that can be observed virtually including the skin exam and signs of difficulty breathing. If it is not possible for your child to come into the office, your pediatrician may recommend a telemedicine visit so they can observe your child. Based on the history and this observed exam, your child’s pediatrician may determine that a bacterial infection is likely and may consider prescribing antibiotics without seeing the child in the office.