Children with either suspected or confirmed JIA may be looked after by a general paediatrician rather than a paediatric rheumatologist in areas around the country where there is no locally based paediatric rheumatologist. However, this care will be shared with specialist centres and the paediatrician will usually work in partnership with the paediatric rheumatologists and the local adult rheumatologist.
Paediatricians are in a unique position to co-ordinate services locally such as, physiotherapy, occupational therapy and eye specialists and to ensure a smooth transition to adult rheumatology services. In addition, they are well placed to initiate treatment in a flare up of symptoms working with the adult rheumatologist, and monitor any side effects of these treatments in a timely manner and importantly, close to a child’s home which lowers the need for frequent trips to specialist centres and causes less disruption to family life, school attendance and related travel expenses.
The role of a paediatrician is to understand the experience and expectations of the child and their family and build partnerships; provide answers and explanations when possible, guide children and their parents through the various appointments; offer balanced discussion of uncertainties and options and recommendations for management based on sound clinical judgement and patient preference. Paediatricians, usually working with the local adult rheumatologist also need to make sure both the child/young person and their parents understand and agree the treatment plans.
The general paediatrician
By Dr Satish Bangladore (Paediatrician)
Original article: 16/12/2014
Next review due: 16/12/2017