Understanding Common Fee Structures in Orthodontics

Understanding Common Fee Structures in Orthodontics

Here's the article outline for 'Understanding Common Fee Structures in Orthodontics' focusing on orthodontic treatment for kids:

Understanding Common Fee Structures in Orthodontics


Regular check-ups are important during orthodontic treatment Child-friendly orthodontic solutions United States.

Navigating the world of orthodontic treatment for kids can feel like trying to solve a complex puzzle, especially when it comes to understanding the costs involved. As a parent, you're probably wondering how orthodontists structure their fees and what you can expect to pay for your child's beautiful smile.


Most orthodontic practices offer several payment approaches that can help make treatment more affordable. The traditional lump-sum payment is still common, where families pay the entire treatment cost upfront, often with a small discount. However, many practices now recognize that not every family can manage a large one-time payment.


Flexible payment plans have become increasingly popular. These typically involve spreading the total cost over the duration of treatment, which might be 18 to 24 months. Monthly payments can range from $100 to $300, depending on the complexity of the treatment and the specific orthodontic needs of your child.


Some orthodontists offer tiered pricing based on the type of treatment. Traditional metal braces might be less expensive compared to ceramic braces or clear aligners. Additionally, many practices now provide free initial consultations, which can help families understand the potential costs without an immediate financial commitment.


Insurance can also play a significant role in managing orthodontic expenses. Many dental insurance plans offer partial coverage for orthodontic treatment, typically covering 25% to 50% of the total cost. Some employers even offer flexible spending accounts that can be used for orthodontic care.


For families with limited financial resources, some orthodontic offices provide income-based discounts or partner with financing companies to create more accessible payment options. It's always worth having an open conversation about financial concerns with the orthodontic office.


Understanding these fee structures can help parents make informed decisions about their child's orthodontic care. The key is to ask questions, explore different payment options, and find a solution that works for your family's budget while ensuring your child receives the best possible care.

Traditional Fee Structures: Per-Treatment Pricing Models in Orthodontics


When it comes to orthodontic treatment, understanding fee structures can feel like navigating a complex maze. Traditional per-treatment pricing models have long been a standard approach for orthodontic practices, offering patients a straightforward way to understand their financial commitment.


In these traditional models, pricing is typically based on the specific treatment required. For instance, a patient needing traditional metal braces might be quoted a different price compared to someone opting for ceramic braces or clear aligners. This approach allows for a more customized pricing strategy that reflects the complexity and duration of individual treatment plans.


The per-treatment model usually encompasses the entire course of orthodontic care, including initial consultations, the treatment itself, and follow-up appointments. This comprehensive approach gives patients a clear picture of their total investment upfront, helping them budget and plan accordingly.


Some orthodontic practices break down their pricing into different tiers. More complex cases, such as those requiring extensive jaw realignment or dealing with severe misalignment, naturally come with a higher price point. Conversely, minor corrections might be more affordable, providing flexibility for patients with varying dental needs.


It's worth noting that many practices now offer flexible payment plans to make these traditional pricing models more accessible. This might include monthly installment options or financing arrangements that help spread the cost over time.


While per-treatment pricing provides transparency, patients should always discuss the specifics with their orthodontist. Each mouth is unique, and treatment plans can vary significantly. A thorough consultation will provide the most accurate pricing information and help patients understand exactly what's included in their proposed treatment.


The goal of these traditional fee structures is ultimately to provide clear, predictable pricing that allows patients to make informed decisions about their orthodontic care. By understanding the nuances of per-treatment pricing, patients can approach their orthodontic journey with confidence and financial clarity.

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Balancing cost and quality when choosing orthodontic care

Balancing cost and quality when choosing orthodontic care

Making an Informed Decision: Balancing Cost and Quality in Orthodontic Care Choosing the right orthodontic treatment is more than just a matter of straightening teeth—it's about finding the perfect balance between financial responsibility and quality healthcare.. As someone who's been through the process, I understand how overwhelming this decision can be. When I first started exploring orthodontic options, I quickly realized that cost isn't everything, but it certainly matters.

Posted by on 2025-02-12

Flexible financing solutions for orthodontic procedures

Flexible financing solutions for orthodontic procedures

Managing the costs of orthodontic procedures can be a significant financial challenge for many families and individuals.. However, with careful planning and strategic use of available financial tools, it's possible to make these essential treatments more affordable and manageable. One of the most effective approaches to handling orthodontic expenses is leveraging health savings accounts (HSAs) and flexible spending accounts (FSAs).

Posted by on 2025-02-12

Insurance Coverage and Impact on Orthodontic Expenses

Insurance Coverage and Impact on Orthodontic Expenses


Navigating the world of orthodontic treatment can be financially challenging, and insurance coverage plays a crucial role in managing these expenses. Most dental insurance plans have varying levels of orthodontic coverage, which can significantly reduce the out-of-pocket costs for patients seeking braces or other corrective treatments.


Typically, dental insurance plans offer orthodontic coverage as a separate benefit, often with lifetime maximum limits. These limits usually range from $1,000 to $3,000 for orthodontic treatment, which can make a substantial difference in overall treatment costs. However, it's important to note that not all plans are created equal. Some insurance providers cover only children under a certain age, while others extend coverage to adults as well.


Many patients are surprised to learn that insurance doesn't always cover the entire cost of orthodontic treatment. Most plans cover approximately 50% of the total expenses, leaving the patient responsible for the remaining balance. This means careful financial planning is essential. Some orthodontic offices offer payment plans or financing options to help make treatment more affordable.


Patients should take the time to carefully review their insurance policy details. Some plans have waiting periods before orthodontic coverage becomes active, while others may require pre-authorization or have specific network requirements. It's always wise to speak directly with your insurance provider and orthodontist to understand the exact extent of your coverage.


For those without comprehensive insurance, there are alternative ways to manage orthodontic expenses. Flexible spending accounts (FSAs), health savings accounts (HSAs), and payment plans can help spread out the cost of treatment. Some orthodontic practices also offer discounts for upfront payments or family treatment plans.


Understanding your insurance coverage can make a significant difference in managing orthodontic expenses. While the process might seem complicated, a little research and communication can help patients find affordable options for achieving their desired smile.

Payment Plan Options for Pediatric Orthodontic Care

When it comes to pediatric orthodontic care, navigating the financial landscape can feel overwhelming for many parents.

Understanding Common Fee Structures in Orthodontics - clear aligner

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Understanding payment plan options can make the journey smoother and more manageable, helping families invest in their child's dental health without breaking the bank.


Most orthodontic practices recognize that comprehensive treatment can be a significant expense, which is why they've developed flexible payment strategies. Typically, parents can choose from several approaches. Many offices offer monthly installment plans that spread the total cost over the duration of treatment, often ranging from 12 to 36 months. These plans usually involve a down payment followed by consistent monthly payments, making budgeting more predictable.


Some practices provide interest-free financing, which can be a game-changer for families watching their expenses. This option allows parents to pay for treatment without accruing additional interest charges, provided they meet specific payment timelines. Additionally, many orthodontists collaborate with third-party financing companies that specialize in healthcare payment solutions, offering customized plans with varying term lengths and interest rates.


Dental insurance can also play a crucial role in managing orthodontic expenses. While coverage varies, many plans offer partial reimbursement for pediatric orthodontic treatment, potentially reducing out-of-pocket costs. Some families also leverage health savings accounts (HSAs) or flexible spending accounts (FSAs) to help cover treatment expenses with pre-tax dollars.


Ultimately, the key is open communication with your orthodontic provider. Most practices are willing to work with families to find a payment strategy that fits their unique financial situation, ensuring that quality dental care remains accessible.

Factors Influencing Orthodontic Treatment Costs

When it comes to orthodontic treatment, the cost can vary widely, and understanding the factors that influence these expenses is crucial for patients considering braces or other corrective dental procedures. Let's break down the key elements that impact the overall price tag of getting that perfect smile.


First and foremost, the complexity of your specific dental issue plays a significant role. Simple alignment problems might require less intensive treatment, while more complicated cases involving severe misalignment, bite issues, or jaw discrepancies will naturally cost more.

Understanding Common Fee Structures in Orthodontics - patient

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Think of it like car repairs - a minor tune-up is way cheaper than a complete engine overhaul.


The type of orthodontic treatment you choose is another major factor. Traditional metal braces tend to be the most affordable option, while ceramic braces, lingual braces, and clear aligners like Invisalign can bump up the price considerably. These more advanced treatments offer aesthetic benefits but come with a higher price tag.


Your geographical location matters too. Orthodontic costs can differ dramatically between urban and rural areas, and even between different states or regions. Big cities with higher living costs typically have more expensive orthodontic services. It's kind of like how a cup of coffee costs more in New York City compared to a small town in the Midwest.


The experience and reputation of the orthodontist also impact pricing. A highly sought-after specialist with years of experience and a stellar reputation might charge more than a newer practitioner just starting out. It's similar to how a renowned chef's restaurant will be pricier than a local diner.


Age is another consideration. Treatment for children and teenagers might be slightly less expensive, as their bones are still growing and more responsive to correction. Adult orthodontic treatment can be more complex and potentially more costly due to less flexible bone structure.


Insurance coverage and payment plans can also significantly affect out-of-pocket expenses. Some dental insurance plans cover a portion of orthodontic treatment, while others might not cover it at all. Many orthodontic offices offer flexible payment plans that can help make the treatment more affordable.


Additional treatments like tooth extractions, preliminary dental work, or ongoing maintenance can also add to the total cost. It's like renovating a house - the initial quote is just the beginning, and unexpected issues can pop up along the way.


The duration of treatment is another key factor. Longer treatment times mean more adjustments, more materials, and more professional time, which all contribute to higher overall costs. A quick six-month alignment will naturally be less expensive than a two-year comprehensive treatment plan.


In conclusion, orthodontic treatment costs are influenced by a complex mix of personal, medical, and professional factors. While the price might seem daunting, many patients find the long-term benefits of a corrected smile well worth the investment. It's always best to consult with multiple orthodontists, understand your specific needs, and explore all available options to find the most suitable and affordable treatment plan.

Comparing Different Orthodontic Practices and Their Pricing Strategies

When it comes to orthodontic care, patients often find themselves navigating a complex landscape of pricing strategies and practice approaches. Understanding the nuanced fee structures in orthodontics can feel like deciphering a complicated puzzle, but it's crucial for making informed decisions about dental treatment.


Different orthodontic practices tend to develop unique pricing models that reflect their individual business philosophies and target patient demographics. Some clinics offer comprehensive treatment packages that include initial consultations, multiple sets of braces or aligners, and follow-up appointments within a single upfront fee. Others might break down costs more granularly, charging separately for initial assessments, treatment phases, and ongoing maintenance.


Pricing can vary significantly based on several key factors. Geographic location plays a substantial role, with urban practices typically charging more than rural clinics due to higher operational costs. The complexity of an individual's dental alignment needs also dramatically impacts pricing - more challenging cases requiring extensive intervention naturally come with higher price tags.


Many modern practices are becoming increasingly transparent about their fee structures, offering flexible payment plans and even financing options to make orthodontic care more accessible. Some clinics provide sliding scale fees or discounts for patients paying in full upfront, while others partner with insurance providers to help manage out-of-pocket expenses.


Technology and treatment approach also influence pricing strategies. Practices utilizing cutting-edge digital scanning and 3D imaging might charge premium rates, reflecting their investment in advanced diagnostic and treatment technologies. Conversely, more traditional practices might maintain more conservative pricing models.


Ultimately, patients should approach orthodontic care as an investment in their long-term health and confidence. While price is undoubtedly important, the quality of care, practitioner expertise, and potential treatment outcomes should equally factor into decision-making.


Comparing different orthodontic practices requires careful research, multiple consultations, and a comprehensive understanding of individual dental needs. By approaching the process systematically and asking detailed questions about fee structures, patients can find high-quality orthodontic care that aligns with both their dental requirements and financial constraints.



Understanding Common Fee Structures in Orthodontics - candy

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Additional Fees and Potential Hidden Expenses in Orthodontic Treatment

When diving into the world of orthodontic treatment, patients often find themselves navigating a complex landscape of fees that extend far beyond the initial quote. While many people assume the price they're initially given covers everything, the reality can be quite different.


Additional fees can pop up in unexpected ways throughout your orthodontic journey. For instance, diagnostic procedures like detailed x-rays, 3D imaging, and comprehensive dental scans might not be included in the base treatment cost. These preliminary assessments can add hundreds of dollars to your total expense.


Emergencies and unexpected adjustments are another potential financial pitfall. Breaking a bracket, needing extra alignment corrections, or requiring specialized attachments can quickly increase your out-of-pocket expenses. Some orthodontic practices charge per-visit fees or have specific rates for emergency repairs that aren't part of the original treatment plan.


Maintenance costs are another area where patients can be caught off guard. Retainers, which are crucial after braces or aligners, can be surprisingly expensive. Custom-fitted retainers can cost anywhere from $100 to $500, and they often need replacement every few years due to wear and tear.


Insurance coverage can be maddeningly complex, with many plans offering only partial orthodontic coverage. Patients might find themselves responsible for a significant percentage of treatment costs, with annual caps that limit reimbursement.


Consultation fees, potential sedation costs for complex procedures, and even specialized cleaning tools can all contribute to a much higher total investment than initially anticipated. It's crucial for patients to have transparent conversations with their orthodontist about potential additional expenses and to get a comprehensive breakdown of all potential costs upfront.


By understanding these potential hidden expenses, patients can better prepare financially and avoid unexpected financial stress during their orthodontic treatment journey.

Long-Term Financial Considerations for Pediatric Orthodontic Care


When parents first learn about potential orthodontic treatment for their children, the initial price tag can feel overwhelming. However, understanding the long-term financial landscape is crucial for making informed decisions about dental healthcare.


Orthodontic treatment isn't just a single expense, but an investment in a child's future health and confidence. While upfront costs might range from $3,000 to $7,000, the potential long-term benefits can far outweigh these initial expenses. Properly aligned teeth can prevent more costly dental interventions later in life, such as complex jaw surgeries or extensive dental repairs.


Many orthodontic practices offer flexible payment plans that can help spread the financial burden over several years. Some options include monthly installment plans, zero-interest financing, and even sliding scale fees based on family income. Dental insurance can also play a significant role, with many plans covering a portion of orthodontic treatment for children.


Parents should also consider the potential psychological benefits. Correcting dental alignment can boost a child's self-esteem and potentially reduce future mental health expenses related to self-image issues. It's not just about straight teeth, but about supporting a child's overall emotional well-being.


Additionally, some orthodontists offer sibling discounts or comprehensive family treatment packages, which can help families manage multiple children's dental needs more affordably. Proactive financial planning and early consultations can help parents navigate these complex considerations more effectively.


Ultimately, viewing orthodontic care as a long-term health investment rather than a short-term expense can help families make more strategic financial decisions.

 

Pediatrics
A pediatrician examines a neonate.
Focus Infants, Children, Adolescents, and Young Adults
Subdivisions Paediatric cardiology, neonatology, critical care, pediatric oncology, hospital medicine, primary care, others (see below)
Significant diseases Congenital diseases, Infectious diseases, Childhood cancer, Mental disorders
Significant tests World Health Organization Child Growth Standards
Specialist Pediatrician
Glossary Glossary of medicine

Pediatrics (American English) also spelled paediatrics (British English), is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, pediatrics covers many of their youth until the age of 18.[1] The American Academy of Pediatrics recommends people seek pediatric care through the age of 21, but some pediatric subspecialists continue to care for adults up to 25.[2][3] Worldwide age limits of pediatrics have been trending upward year after year.[4] A medical doctor who specializes in this area is known as a pediatrician, or paediatrician. The word pediatrics and its cognates mean "healer of children", derived from the two Greek words: παá¿–ς (pais "child") and á¼°ατρÏŒς (iatros "doctor, healer"). Pediatricians work in clinics, research centers, universities, general hospitals and children's hospitals, including those who practice pediatric subspecialties (e.g. neonatology requires resources available in a NICU).

History

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Part of Great Ormond Street Hospital in London, United Kingdom, which was the first pediatric hospital in the English-speaking world.

The earliest mentions of child-specific medical problems appear in the Hippocratic Corpus, published in the fifth century B.C., and the famous Sacred Disease. These publications discussed topics such as childhood epilepsy and premature births. From the first to fourth centuries A.D., Greek philosophers and physicians Celsus, Soranus of Ephesus, Aretaeus, Galen, and Oribasius, also discussed specific illnesses affecting children in their works, such as rashes, epilepsy, and meningitis.[5] Already Hippocrates, Aristotle, Celsus, Soranus, and Galen[6] understood the differences in growing and maturing organisms that necessitated different treatment: Ex toto non sic pueri ut viri curari debent ("In general, boys should not be treated in the same way as men").[7] Some of the oldest traces of pediatrics can be discovered in Ancient India where children's doctors were called kumara bhrtya.[6]

Even though some pediatric works existed during this time, they were scarce and rarely published due to a lack of knowledge in pediatric medicine. Sushruta Samhita, an ayurvedic text composed during the sixth century BCE, contains the text about pediatrics.[8] Another ayurvedic text from this period is Kashyapa Samhita.[9][10] A second century AD manuscript by the Greek physician and gynecologist Soranus of Ephesus dealt with neonatal pediatrics.[11] Byzantine physicians Oribasius, Aëtius of Amida, Alexander Trallianus, and Paulus Aegineta contributed to the field.[6] The Byzantines also built brephotrophia (crêches).[6] Islamic Golden Age writers served as a bridge for Greco-Roman and Byzantine medicine and added ideas of their own, especially Haly Abbas, Yahya Serapion, Abulcasis, Avicenna, and Averroes. The Persian philosopher and physician al-Razi (865–925), sometimes called the father of pediatrics, published a monograph on pediatrics titled Diseases in Children.[12][13] Also among the first books about pediatrics was Libellus [Opusculum] de aegritudinibus et remediis infantium 1472 ("Little Book on Children Diseases and Treatment"), by the Italian pediatrician Paolo Bagellardo.[14][5] In sequence came Bartholomäus Metlinger's Ein Regiment der Jungerkinder 1473, Cornelius Roelans (1450–1525) no title Buchlein, or Latin compendium, 1483, and Heinrich von Louffenburg (1391–1460) Versehung des Leibs written in 1429 (published 1491), together form the Pediatric Incunabula, four great medical treatises on children's physiology and pathology.[6]

While more information about childhood diseases became available, there was little evidence that children received the same kind of medical care that adults did.[15] It was during the seventeenth and eighteenth centuries that medical experts started offering specialized care for children.[5] The Swedish physician Nils Rosén von Rosenstein (1706–1773) is considered to be the founder of modern pediatrics as a medical specialty,[16][17] while his work The diseases of children, and their remedies (1764) is considered to be "the first modern textbook on the subject".[18] However, it was not until the nineteenth century that medical professionals acknowledged pediatrics as a separate field of medicine. The first pediatric-specific publications appeared between the 1790s and the 1920s.[19]

Etymology

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The term pediatrics was first introduced in English in 1859 by Abraham Jacobi. In 1860, he became "the first dedicated professor of pediatrics in the world."[20] Jacobi is known as the father of American pediatrics because of his many contributions to the field.[21][22] He received his medical training in Germany and later practiced in New York City.[23]

The first generally accepted pediatric hospital is the Hôpital des Enfants Malades (French: Hospital for Sick Children), which opened in Paris in June 1802 on the site of a previous orphanage.[24] From its beginning, this famous hospital accepted patients up to the age of fifteen years,[25] and it continues to this day as the pediatric division of the Necker-Enfants Malades Hospital, created in 1920 by merging with the nearby Necker Hospital, founded in 1778.[26]

In other European countries, the Charité (a hospital founded in 1710) in Berlin established a separate Pediatric Pavilion in 1830, followed by similar institutions at Saint Petersburg in 1834, and at Vienna and Breslau (now WrocÅ‚aw), both in 1837. In 1852 Britain's first pediatric hospital, the Hospital for Sick Children, Great Ormond Street was founded by Charles West.[24] The first Children's hospital in Scotland opened in 1860 in Edinburgh.[27] In the US, the first similar institutions were the Children's Hospital of Philadelphia, which opened in 1855, and then Boston Children's Hospital (1869).[28] Subspecialties in pediatrics were created at the Harriet Lane Home at Johns Hopkins by Edwards A. Park.[29]

Differences between adult and pediatric medicine

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The body size differences are paralleled by maturation changes. The smaller body of an infant or neonate is substantially different physiologically from that of an adult. Congenital defects, genetic variance, and developmental issues are of greater concern to pediatricians than they often are to adult physicians. A common adage is that children are not simply "little adults". The clinician must take into account the immature physiology of the infant or child when considering symptoms, prescribing medications, and diagnosing illnesses.[30]

Pediatric physiology directly impacts the pharmacokinetic properties of drugs that enter the body. The absorption, distribution, metabolism, and elimination of medications differ between developing children and grown adults.[30][31][32] Despite completed studies and reviews, continual research is needed to better understand how these factors should affect the decisions of healthcare providers when prescribing and administering medications to the pediatric population.[30]

Absorption

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Many drug absorption differences between pediatric and adult populations revolve around the stomach. Neonates and young infants have increased stomach pH due to decreased acid secretion, thereby creating a more basic environment for drugs that are taken by mouth.[31][30][32] Acid is essential to degrading certain oral drugs before systemic absorption. Therefore, the absorption of these drugs in children is greater than in adults due to decreased breakdown and increased preservation in a less acidic gastric space.[31]

Children also have an extended rate of gastric emptying, which slows the rate of drug absorption.[31][32]

Drug absorption also depends on specific enzymes that come in contact with the oral drug as it travels through the body. Supply of these enzymes increase as children continue to develop their gastrointestinal tract.[31][32] Pediatric patients have underdeveloped proteins, which leads to decreased metabolism and increased serum concentrations of specific drugs. However, prodrugs experience the opposite effect because enzymes are necessary for allowing their active form to enter systemic circulation.[31]

Distribution

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Percentage of total body water and extracellular fluid volume both decrease as children grow and develop with time. Pediatric patients thus have a larger volume of distribution than adults, which directly affects the dosing of hydrophilic drugs such as beta-lactam antibiotics like ampicillin.[31] Thus, these drugs are administered at greater weight-based doses or with adjusted dosing intervals in children to account for this key difference in body composition.[31][30]

Infants and neonates also have fewer plasma proteins. Thus, highly protein-bound drugs have fewer opportunities for protein binding, leading to increased distribution.[30]

Metabolism

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Drug metabolism primarily occurs via enzymes in the liver and can vary according to which specific enzymes are affected in a specific stage of development.[31] Phase I and Phase II enzymes have different rates of maturation and development, depending on their specific mechanism of action (i.e. oxidation, hydrolysis, acetylation, methylation, etc.). Enzyme capacity, clearance, and half-life are all factors that contribute to metabolism differences between children and adults.[31][32] Drug metabolism can even differ within the pediatric population, separating neonates and infants from young children.[30]

Elimination

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Drug elimination is primarily facilitated via the liver and kidneys.[31] In infants and young children, the larger relative size of their kidneys leads to increased renal clearance of medications that are eliminated through urine.[32] In preterm neonates and infants, their kidneys are slower to mature and thus are unable to clear as much drug as fully developed kidneys. This can cause unwanted drug build-up, which is why it is important to consider lower doses and greater dosing intervals for this population.[30][31] Diseases that negatively affect kidney function can also have the same effect and thus warrant similar considerations.[31]

Pediatric autonomy in healthcare

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A major difference between the practice of pediatric and adult medicine is that children, in most jurisdictions and with certain exceptions, cannot make decisions for themselves. The issues of guardianship, privacy, legal responsibility, and informed consent must always be considered in every pediatric procedure. Pediatricians often have to treat the parents and sometimes, the family, rather than just the child. Adolescents are in their own legal class, having rights to their own health care decisions in certain circumstances. The concept of legal consent combined with the non-legal consent (assent) of the child when considering treatment options, especially in the face of conditions with poor prognosis or complicated and painful procedures/surgeries, means the pediatrician must take into account the desires of many people, in addition to those of the patient.[citation needed]

History of pediatric autonomy

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The term autonomy is traceable to ethical theory and law, where it states that autonomous individuals can make decisions based on their own logic.[33] Hippocrates was the first to use the term in a medical setting. He created a code of ethics for doctors called the Hippocratic Oath that highlighted the importance of putting patients' interests first, making autonomy for patients a top priority in health care.[34]  

In ancient times, society did not view pediatric medicine as essential or scientific.[35] Experts considered professional medicine unsuitable for treating children. Children also had no rights. Fathers regarded their children as property, so their children's health decisions were entrusted to them.[5] As a result, mothers, midwives, "wise women", and general practitioners treated the children instead of doctors.[35] Since mothers could not rely on professional medicine to take care of their children, they developed their own methods, such as using alkaline soda ash to remove the vernix at birth and treating teething pain with opium or wine. The absence of proper pediatric care, rights, and laws in health care to prioritize children's health led to many of their deaths. Ancient Greeks and Romans sometimes even killed healthy female babies and infants with deformities since they had no adequate medical treatment and no laws prohibiting infanticide.[5]

In the twentieth century, medical experts began to put more emphasis on children's rights. In 1989, in the United Nations Rights of the Child Convention, medical experts developed the Best Interest Standard of Child to prioritize children's rights and best interests. This event marked the onset of pediatric autonomy. In 1995, the American Academy of Pediatrics (AAP) finally acknowledged the Best Interest Standard of a Child as an ethical principle for pediatric decision-making, and it is still being used today.[34]

Parental authority and current medical issues

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The majority of the time, parents have the authority to decide what happens to their child. Philosopher John Locke argued that it is the responsibility of parents to raise their children and that God gave them this authority. In modern society, Jeffrey Blustein, modern philosopher and author of the book Parents and Children: The Ethics of Family, argues that parental authority is granted because the child requires parents to satisfy their needs. He believes that parental autonomy is more about parents providing good care for their children and treating them with respect than parents having rights.[36] The researcher Kyriakos Martakis, MD, MSc, explains that research shows parental influence negatively affects children's ability to form autonomy. However, involving children in the decision-making process allows children to develop their cognitive skills and create their own opinions and, thus, decisions about their health. Parental authority affects the degree of autonomy the child patient has. As a result, in Argentina, the new National Civil and Commercial Code has enacted various changes to the healthcare system to encourage children and adolescents to develop autonomy. It has become more crucial to let children take accountability for their own health decisions.[37]

In most cases, the pediatrician, parent, and child work as a team to make the best possible medical decision. The pediatrician has the right to intervene for the child's welfare and seek advice from an ethics committee. However, in recent studies, authors have denied that complete autonomy is present in pediatric healthcare. The same moral standards should apply to children as they do to adults. In support of this idea is the concept of paternalism, which negates autonomy when it is in the patient's interests. This concept aims to keep the child's best interests in mind regarding autonomy. Pediatricians can interact with patients and help them make decisions that will benefit them, thus enhancing their autonomy. However, radical theories that question a child's moral worth continue to be debated today.[37] Authors often question whether the treatment and equality of a child and an adult should be the same. Author Tamar Schapiro notes that children need nurturing and cannot exercise the same level of authority as adults.[38] Hence, continuing the discussion on whether children are capable of making important health decisions until this day.

Modern advancements

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According to the Subcommittee of Clinical Ethics of the Argentinean Pediatric Society (SAP), children can understand moral feelings at all ages and can make reasonable decisions based on those feelings. Therefore, children and teens are deemed capable of making their own health decisions when they reach the age of 13. Recently, studies made on the decision-making of children have challenged that age to be 12.[37]

Technology has made several modern advancements that contribute to the future development of child autonomy, for example, unsolicited findings (U.F.s) of pediatric exome sequencing. They are findings based on pediatric exome sequencing that explain in greater detail the intellectual disability of a child and predict to what extent it will affect the child in the future. Genetic and intellectual disorders in children make them incapable of making moral decisions, so people look down upon this kind of testing because the child's future autonomy is at risk. It is still in question whether parents should request these types of testing for their children. Medical experts argue that it could endanger the autonomous rights the child will possess in the future. However, the parents contend that genetic testing would benefit the welfare of their children since it would allow them to make better health care decisions.[39] Exome sequencing for children and the decision to grant parents the right to request them is a medically ethical issue that many still debate today.

Education requirements

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Aspiring medical students will need 4 years of undergraduate courses at a college or university, which will get them a BS, BA or other bachelor's degree. After completing college, future pediatricians will need to attend 4 years of medical school (MD/DO/MBBS) and later do 3 more years of residency training, the first year of which is called "internship." After completing the 3 years of residency, physicians are eligible to become certified in pediatrics by passing a rigorous test that deals with medical conditions related to young children.[citation needed]

In high school, future pediatricians are required to take basic science classes such as biology, chemistry, physics, algebra, geometry, and calculus. It is also advisable to learn a foreign language (preferably Spanish in the United States) and be involved in high school organizations and extracurricular activities. After high school, college students simply need to fulfill the basic science course requirements that most medical schools recommend and will need to prepare to take the MCAT (Medical College Admission Test) in their junior or early senior year in college. Once attending medical school, student courses will focus on basic medical sciences like human anatomy, physiology, chemistry, etc., for the first three years, the second year of which is when medical students start to get hands-on experience with actual patients.[40]

Training of pediatricians

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Pediatrics
Occupation
Names
  • Pediatrician
  • Paediatrician
Occupation type
Specialty
Activity sectors
Medicine
Description
Education required
  • Doctor of Medicine
  • Doctor of Osteopathic Medicine
  • Bachelor of Medicine, Bachelor of Surgery (MBBS/MBChB)
Fields of
employment
Hospitals, Clinics

The training of pediatricians varies considerably across the world. Depending on jurisdiction and university, a medical degree course may be either undergraduate-entry or graduate-entry. The former commonly takes five or six years and has been usual in the Commonwealth. Entrants to graduate-entry courses (as in the US), usually lasting four or five years, have previously completed a three- or four-year university degree, commonly but by no means always in sciences. Medical graduates hold a degree specific to the country and university in and from which they graduated. This degree qualifies that medical practitioner to become licensed or registered under the laws of that particular country, and sometimes of several countries, subject to requirements for "internship" or "conditional registration".

Pediatricians must undertake further training in their chosen field. This may take from four to eleven or more years depending on jurisdiction and the degree of specialization.

In the United States, a medical school graduate wishing to specialize in pediatrics must undergo a three-year residency composed of outpatient, inpatient, and critical care rotations. Subspecialties within pediatrics require further training in the form of 3-year fellowships. Subspecialties include critical care, gastroenterology, neurology, infectious disease, hematology/oncology, rheumatology, pulmonology, child abuse, emergency medicine, endocrinology, neonatology, and others.[41]

In most jurisdictions, entry-level degrees are common to all branches of the medical profession, but in some jurisdictions, specialization in pediatrics may begin before completion of this degree. In some jurisdictions, pediatric training is begun immediately following the completion of entry-level training. In other jurisdictions, junior medical doctors must undertake generalist (unstreamed) training for a number of years before commencing pediatric (or any other) specialization. Specialist training is often largely under the control of 'pediatric organizations (see below) rather than universities and depends on the jurisdiction.

Subspecialties

[edit]

Subspecialties of pediatrics include:

(not an exhaustive list)

  • Addiction medicine (multidisciplinary)
  • Adolescent medicine
  • Child abuse pediatrics
  • Clinical genetics
  • Clinical informatics
  • Developmental-behavioral pediatrics
  • Headache medicine
  • Hospital medicine
  • Medical toxicology
  • Metabolic medicine
  • Neonatology/Perinatology
  • Pain medicine (multidisciplinary)
  • Palliative care (multidisciplinary)
  • Pediatric allergy and immunology
  • Pediatric cardiology
    • Pediatric cardiac critical care
  • Pediatric critical care
    • Neurocritical care
    • Pediatric cardiac critical care
  • Pediatric emergency medicine
  • Pediatric endocrinology
  • Pediatric gastroenterology
    • Transplant hepatology
  • Pediatric hematology
  • Pediatric infectious disease
  • Pediatric nephrology
  • Pediatric oncology
    • Pediatric neuro-oncology
  • Pediatric pulmonology
  • Primary care
  • Pediatric rheumatology
  • Sleep medicine (multidisciplinary)
  • Social pediatrics
  • Sports medicine

Other specialties that care for children

[edit]

(not an exhaustive list)

  • Child neurology
    • Addiction medicine (multidisciplinary)
    • Brain injury medicine
    • Clinical neurophysiology
    • Epilepsy
    • Headache medicine
    • Neurocritical care
    • Neuroimmunology
    • Neuromuscular medicine
    • Pain medicine (multidisciplinary)
    • Palliative care (multidisciplinary)
    • Pediatric neuro-oncology
    • Sleep medicine (multidisciplinary)
  • Child and adolescent psychiatry, subspecialty of psychiatry
  • Neurodevelopmental disabilities
  • Pediatric anesthesiology, subspecialty of anesthesiology
  • Pediatric dentistry, subspecialty of dentistry
  • Pediatric dermatology, subspecialty of dermatology
  • Pediatric gynecology
  • Pediatric neurosurgery, subspecialty of neurosurgery
  • Pediatric ophthalmology, subspecialty of ophthalmology
  • Pediatric orthopedic surgery, subspecialty of orthopedic surgery
  • Pediatric otolaryngology, subspecialty of otolaryngology
  • Pediatric plastic surgery, subspecialty of plastic surgery
  • Pediatric radiology, subspecialty of radiology
  • Pediatric rehabilitation medicine, subspecialty of physical medicine and rehabilitation
  • Pediatric surgery, subspecialty of general surgery
  • Pediatric urology, subspecialty of urology

See also

[edit]
  • American Academy of Pediatrics
  • American Osteopathic Board of Pediatrics
  • Center on Media and Child Health (CMCH)
  • Children's hospital
  • List of pediatric organizations
  • List of pediatrics journals
  • Medical specialty
  • Pediatric Oncall
  • Pain in babies
  • Royal College of Paediatrics and Child Health
  • Pediatric environmental health

References

[edit]
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  20. ^ Stern, Alexandra Minna; Markel, Howard (2002). Formative Years: Children's Health in the United States, 1880-2000. University of Michigan Press. pp. 23–24. doi:10.3998/mpub.17065. ISBN 978-0-472-02503-9. Archived from the original on 30 November 2021. Retrieved 30 November 2021.
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  23. ^ Kutzsche, Stefan (8 April 2021). "Abraham Jacobi (1830–1919) and his transition from political to medical activist". Acta Paediatrica. 110 (8): 2303–2305. doi:10.1111/apa.15887. ISSN 0803-5253. PMID 33963612. S2CID 233998658. Archived from the original on 7 May 2023. Retrieved 7 May 2023.
  24. ^ a b Ballbriga, Angel (1991). "One century of pediatrics in Europe (section: development of pediatric hospitals in Europe)". In Nichols, Burford L.; et al. (eds.). History of Paediatrics 1850–1950. Nestlé Nutrition Workshop Series. Vol. 22. New York: Raven Press. pp. 6–8. ISBN 0-88167-695-0.
  25. ^ official history site (in French) of nineteenth century paediatric hospitals in Paris
  26. ^ "Introducing the Necker-Enfants Malades Hospital". Hôpital des Necker-Enfants Malades.
  27. ^ Young, D.G. (August 1999). "The Mason Brown Lecture: Scots and paediatric surgery". Journal of the Royal College of Surgeons Edinburgh. 44 (4): 211–5. PMID 10453141. Archived from the original on 14 July 2014.
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  33. ^ Katz, Aviva L.; Webb, Sally A.; COMMITTEE ON BIOETHICS; Macauley, Robert C.; Mercurio, Mark R.; Moon, Margaret R.; Okun, Alexander L.; Opel, Douglas J.; Statter, Mindy B. (1 August 2016). "Informed Consent in Decision-Making in Pediatric Practice". Pediatrics. 138 (2): e20161485. doi:10.1542/peds.2016-1485. ISSN 0031-4005. PMID 27456510. S2CID 7951515.
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  39. ^ Dondorp, W.; Bolt, I.; Tibben, A.; De Wert, G.; Van Summeren, M. (1 September 2021). "'We Should View Him as an Individual': The Role of the Child's Future Autonomy in Shared Decision-Making About Unsolicited Findings in Pediatric Exome Sequencing". Health Care Analysis. 29 (3): 249–261. doi:10.1007/s10728-020-00425-7. ISSN 1573-3394. PMID 33389383. S2CID 230112761.
  40. ^ "What Education Is Required to Be a Pediatrician?". Archived from the original on 7 June 2017. Retrieved 14 June 2017.
  41. ^ "CoPS". www.pedsubs.org. Archived from the original on 18 September 2013. Retrieved 14 August 2015.

Further reading

[edit]
  • BMC Pediatrics - open access
  • Clinical Pediatrics
  • Developmental Review - partial open access
  • JAMA Pediatrics
  • The Journal of Pediatrics - partial open access
[edit]
  • Pediatrics Directory at Curlie
  • Pediatric Health Directory at OpenMD

 

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Frequently Asked Questions

Between ages 9-14 is typically most cost-effective, as early intervention can prevent more complex and expensive treatments later.