Pediatricians child care today inadequate

Pediatricians call for better checkups

18/06/2011

Germany's paediatricians call for a reform of the check-ups. The problems of children are different today than they were 40 years ago. The current prevention programs are according to the professional association of children and youth physicians „not up to date anymore“.

Children today are exposed to a high-fat and high-sugar diet. Excessive medial consumption also causes more and more massive behavioral problems. The Association of German Pediatricians therefore warns in an appeal against the consequences of these (mis) developments. Nowadays, when children and adolescents go to the doctor, the problems are different than they were forty years ago. For this reason, preventive care programs urgently need to be adapted and reformed, according to the admonition of pediatricians.

Disease early detection program is more than 40 years old
The then inclusion of the early disease detection program for children in the catalog of benefits of the statutory health insurance in 1971 revolutionized the health of children. Germany was a pioneer of child care at that time. Many countries then followed the creation of regularly scheduled examination dates, the so-called U-studies and also developed equivalent programs. The aim of the preventive examinations was to detect any undesirable developments or disorders in good time in order to treat them as early as possible. As a result, hundreds of thousands of children were prevented from chronic diseases and deformities. The focus was on the detection of metabolic diseases, developmental delays, behavioral disorders, diseases of the nervous system, the sensory organs such as eyes, ears and nose as well as the timely detection and treatment of malformations of the teeth. It was therefore mainly about health checks and timely child protection vaccines.

Pediatricians demand reform of child care
Since then, over 40 years have passed. Society and thus the growing up of children has changed fundamentally since then. Therefore, the doctors call for a reform of the check-ups from infancy to adolescence. „We must move away from the old concept of early detection, ie the earliest possible recognition of existing diseases (so-called secondary prevention), to the concept of preventing the onset of disease, ie primary prevention“. Because the prevention programs are more up-to-date, said the chairman of the professional association of paediatricians, Dr. med. Wolfram Hartmann, on Friday in Berlin.

Behavioral and overweight
The diseases of the children in the year 2011 differ in part severely from the children 40 years ago. Therefore, young medical doctors speak of „new diseases“ the young patient. According to a scientific study, about 14 percent of all children are overweight. Six percent showed morbid obesity at a young age. The most serious sequelae is diabetes type II. At the time of the introduction of the program, it was not even possible to think that even small children were already suffering from diabetes „age-related diabetes“ could suffer. Also unimaginable were psychological suffering such as depression. According to child and adolescent psychiatry, up to 7 percent of children already suffer from depressive episodes. If parents are not very dedicated and children orient themselves to media models from the internet or television, episodes can even lead to manifest behavioral problems. Another seven percent show disturbed social behavior, develop social phobias, suffer from difficulty concentrating or show attention deficits. If the children come from socially disadvantaged families, often motor difficulties as well as disturbances of speech and language are observed.

After all, 90 percent of parents go regularly with their children to the examinations. However, enough „the 20-minute consultations with the pediatrician“ in today's indicators are no longer enough. „We are very worried about the growing number of children with developmental deficits, especially language, cognition, social behavior, but also motor skills, which are already largely failing at school with these handicaps.“ said Dr. Dr. Hartmann. Physicians should also explain and explain to parents how to read a book together with their children. Day-care centers and schools should also become partners of paediatricians in order to compensate for the existing difficulties. „A good kindergarten is better for a child's speech development than a speech therapist“, says the spokesman for the association Fegeler. If a youth center is pedagogically well looked after, it saves even some therapists.

Pension shortages at primary school age
As unacceptable, the professional association sees the supply gap in elementary school. Because by no means all statutory health insurance funds are already the investigations (U10 and U11) to finance. The U-Checks are mainly about spelling, reading and calculation problems. Social competence and media consumption are also the focus of doctors at check-ups. Although especially children from socially disadvantaged families are affected, these are considered to be particularly underserved. „Between the ages of 6 and 10, patients have no legal entitlement to such examinations“. Only children of privately insured parents are entitled to an annual check-up between 2 and 14 years of age. This is a two-class medicine against which the association has been going for decades.

„There is also great concern about the large number of overweight children with metabolic imbalances, who will suffer early from cardiovascular diseases or diabetes mellitus.“ admonishes Dr. Hartmann. Primary preventive care could extend life expectancy and, moreover, save costs in the healthcare system because later long-term therapies will disappear. Therefore, the association calls for implementing the already designed precautionary concept, even if it is more complicated and more expensive than the previous one. But in perspective, it saves costs. Increasing vaccine fatigue was also noted by doctors. Two children have already died from measles in the current year. Therefore, one speaks for a general vaccination. In Germany, vaccinations are voluntary. (Sb)

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Picture: Jutta Rotter