Momwithastethoscope's Weblog

September 19, 2009

Loving Pediatric Medicine – the anti-rant

Filed under: Office,pediatrics,positive medicine — momwithastethoscope @ 7:32 am
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Reason Number 19:  Specialty in a specialty

At one point in my career, I wondered if I had taken a wrong turn by choosing general pediatrics.  As a resident, my neonatology attending encouraged me to subspecialize – preferably in neonatology.  While I really enjoyed the NICU – the rotation allowed me to do procedures, attend deliveries, care for really sick patients, and care for unusual problems – the ethical dilemas I encountered took their toll on my young interests.  This attending told me I would be bored in general pediatrics taking care of runny nose after runny nose. 

I have never been bored in general pediatrics. Quite the opposite.  Just when I think that my practice is humdrum, a patient will arrive with a zebra – a problem seen mostly in textbooks and on board exams.  My medical curiosity will smack me between the eyes as I dig in annals and journals and zebra websites.  So that time I was pondering the value of general pediatrics was not from the mundane.  Instead and because of the amount of information I am expected to keep in my cranium, I pondered fine tuning my specialty choice. 

I applied for fellowship in a very competitive specialty, dermatology, and as no surprise to anyone but me, I was not chosen for the extra training despite a shortage of pediatric dermatologists in the area.  No regrets about the experience.  I am meant to be in general pediatrics. 

Now with partners and the prowess of mentors, I see myself able to specialize in an informal way.  Already, my nurses will say to my younger partners, “Ask Dr. MWAS about that – she likes rashes.” Fellow pediatricans in my town have marketed themselves as “specialists” in ADD or autism.  I’m not ready to market myself, but I do see that I can develop a niche in my own practice.  It’s nice to be able to refer to my own partners because of special interests they have in areas of pediatrics.

So I may never hang the shingle for pediatric derm at my office, but my scheduling staff steers dermatological concerns my way.  And I’ll keep working on that knowledge base so that maybe one day I can trade a day of general pediatrics for pediatric dermatology.


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