Child health centre physician

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Child health centre physician

Within Dutch child welfare a distinction is being made between care for infants (0-4 years) and children (0-19 years). This article concerns the so-called consultatiebureau-arts ('child health centre physician'). The child health centre physician is involved in the care for infants 0-4 years, while the jeugdarts ('youth physician') is involved in the care for children 0-19 years. Both types of physician are concerned with prevention: their objective is the timely identification of existing or potential health issues and to monitor all relevant factors pertaining to the development of the child. The population of Dutch child health centres basically consists of all healthy children between 0 and 4 years. Nearly all infants in the Netherlands are being monitored.

Contents=

  • Training of the child health centre physician
  • Duties
  • Author
  • Tags

Training

The child health centre physician is a basisarts ('basic physician'), i.e. s/he has a medical school degree supplemented with at least a six-day basic course especially for child health centre physicians covering the most important issues that come with the job. This includes examining and monitoring of both the physical and social and emotional development of the child in all its aspects. Furthermore each junior child health centre physician is shown the ropes by an experienced colleague. The basic course also constitutes a stepping stone towards the training for youth physician (0-19 years). This is a specialization recognized by the Royal Dutch Medical Association (KNMG), the professional organization for physicians of the Netherlands. The training takes 2 years (full-time) or 3-4 years (part-time). Due to the difference in duration of the training and the difference in age range on which the respective trainings focus, there is also a difference in competence: the child health centre physician can only refer via the general practitioner. The youth physician (0-19 years) on the other hand is qualified to refer independently but this involves additional requirements, among other things advanced training courses.

Duties

As mentioned above, the duties of the child health centre physician are focussed on primary prevention: the timely identification of potential problems c.q. diseases in young children 0-4 years in the broadest sense possible. This concerns issues already manifest or indications that suggest problems in a later stage. In case of medical issues it is the physician's duty to refer to a general practitioner or to monitor the situation, i.e. to systematically examine the development of the problem over a longer period of time. Summarizing it may be said that the duties of the child health centre physician comprise all common preventive and social-medical tasks such as examination, identification of problems, counselling, advice and registration of the physical, social and emotional development of the child. In the event of manifest deviations from the norm the child health centre physician counsels and/or advises or refers to the general practitioner. The timely administration of vaccinations and, if required, the ultrasound of baby's hips when the child is 3 months old, the continuity of care during the transfer to the care of the school medical officer fall also within the responsibilities of the child health centre physician. It goes without saying that the child health centre physician is also involved in addressing the queries, uncertainties and problems experienced by mothers regarding the care for and interaction with her baby. Controversial issues can be:

  • Breastfeeding, its benefits and disadvantages, also in social perspective as for instance for working mothers. Potential solutions
  • Issues pertaining to baby's sleeping through the night — can it be done and how
  • Benefits and disadvantages of rubber teats
  • Various responses to baby's crying and their effects.

The child health centre physician works closely with the district nurse. They often alternately give consultations.

Author

The first version of this article was written in cooperation with Marijke Zwart- Van Meeteren.

Key Words

Consultatiebureau, child health centre, consultatiebureau-arts, physician

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