Re: What is part of a well child check

[Guest guest]

4 parts ot a wcc

-hx inlcuding nutrition who is in the house smoking in the house family

status etc illness injury etc

-milestones i like the 4 yr old one the bestw hen i get to ask them to draw

Mom or dad and have to count bosy parts- 4 to pass

speech walking etc

-exam least important

-anticpatory guidance don 't eventhink about having sex til you are 28

etc

then immunizations and any screenign labs like lead etc

There are stadnard templates for each Mine came form teh state

What is part of a well child check

Next week, I am going to do my first well child checks (3 and 7 years

old). I wonder: what HAS to be part of a well child check other than a

normal H & P? Do I have to do audiometry or vision checks? If so, any

recommendations for an audiometer and where to get a large Snellen card?

Also, I am open to suggestions as to other interesting activities that

IMPers include in their well child checks (such as playing games etc.).

Thanks, Marius

[Guest guest]

Marius

pretty much covered it. Exam least important.

There are published guidelines for anticipatory guidance and

recommended screenings, if not from the state, then from your academy.

Development is very important. Chatting with the kids,

seeing how they interact. Knowing their names, phone numbers, parents

names. Usually reassuring the parent that they aren’t underweight

and really don’t eat a lot. Remember a portion is handful. If

it’s the before kindergarten physical, in NJ, it requires vision

screening and I have them count and name colors. Hearing can’t be

screen easily until they can understand the directions. NJ has rules for

certain EPSDT exams which I have just stopped doing as too time consuming

(Early Prevention Screening Diagnostic Testing). It is extra money from

Medicaid but not enough to make up for the extra time. Watch them walk,

climb, pick things up (pincer grasp).

Just wondering where you got your training though, and what kind

of training. I don’t truly remember what it was like when I first

started on my own, so to speak, and I had a partner to rely on, but you have a

lot of questions that I learned in residency and was pretty comfortable with

before entering private practice.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Jean

Antonucci

Sent: Sunday, September 23, 2007 7:08 PM

To: 'Marius Laumans '; ' '

Subject: RE: What is part of a well child check

4 parts ot a wcc

-hx inlcuding nutrition who is in the house smoking in the house family

status etc illness injury etc

-milestones i like the 4 yr old one the bestw hen i get to ask them to draw

Mom or dad and have to count bosy parts- 4 to pass

speech walking etc

-exam least important

-anticpatory guidance don 't eventhink about having sex til you are 28

etc

then immunizations and any screenign labs like lead etc

There are stadnard templates for each Mine came form teh state

What is part of a well child check

Next week, I am going to do my first well child checks (3 and 7 years

old). I wonder: what HAS to be part of a well child check other than a

normal H & P? Do I have to do audiometry or vision checks? If so, any

recommendations for an audiometer and where to get a large Snellen card?

Also, I am open to suggestions as to other interesting activities that

IMPers include in their well child checks (such as playing games etc.).

Thanks, Marius

[Guest guest]

Look up "epsdt" -- these are national standards.

Did you not get training to know what are the standards?

FP solo in Western PA

What is part of a well child check

Next week, I am going to do my first well child checks (3 and 7 yearsold). I wonder: what HAS to be part of a well child check other than anormal H & P? Do I have to do audiometry or vision checks? If so, anyrecommendations for an audiometer and where to get a large Snellen card? Also, I am open to suggestions as to other interesting activities thatIMPers include in their well child checks (such as playing games etc.).Thanks, Marius

[Guest guest]

Mariusif you are using IMH, it has a reasonable WCC history, however, not quite as good as the one that you can do. Good for populating the note though.Agree with below.Also use BrightFutures.org for handouts for anticipatory guidance- download and hand out- tip from ?Gordon- someone on the list serve.LynnTo: mllaumans@...; From: jantonucci@...Date: Sun, 23 Sep 2007 19:07:35 -0400Subject: RE: What is part of a well child check

4 parts ot a wcc

-hx inlcuding nutrition who is in the house smoking in the house family

status etc illness injury etc

-milestones i like the 4 yr old one the bestw hen i get to ask them to draw

Mom or dad and have to count bosy parts- 4 to pass

speech walking etc

-exam least important

-anticpatory guidance don 't eventhink about having sex til you are 28

etc

then immunizations and any screenign labs like lead etc

There are stadnard templates for each Mine came form teh state

What is part of a well child check

Next week, I am going to do my first well child checks (3 and 7 years

old). I wonder: what HAS to be part of a well child check other than a

normal H & P? Do I have to do audiometry or vision checks? If so, any

recommendations for an audiometer and where to get a large Snellen card?

Also, I am open to suggestions as to other interesting activities that

IMPers include in their well child checks (such as playing games etc.).

Thanks, Marius

Make your little one a shining star! Shine on!

[Guest guest]

Hi Marius,

I've already mentioned all the fun games/gifts that I give at WCCs but

forthe group (since I do 1 hour WCCs) I will share that I basically

make the encounter funby teaching them about all the equipment

and how to check their femoral, carotid pulse, how to use

the opthalmoscope and we experiment with other willing

family members in the room. I have them guess their wt before

they get on the scale. I give ungames to kids with emotionally

rough issues in their lives and I teach them how to express themselves

through use of the game.

Ungame is also a popular gift for other ages as well. Here is some info

on it. I get the pocket version. It's about $8 for a deck of cards.

http://www.educationallearninggames.com/ungame.asp

I got my snellen chart at Besse.com where I get my supplies

I really love WCCs in the ideal relationship-based model

Pamela

>

> Next week, I am going to do my first well child checks (3 and 7 years

> old). I wonder: what HAS to be part of a well child check other than a

> normal H & P? Do I have to do audiometry or vision checks? If so, any

> recommendations for an audiometer and where to get a large Snellen card?

>

> Also, I am open to suggestions as to other interesting activities that

> IMPers include in their well child checks (such as playing games etc.).

>

> Thanks, Marius

>

[Guest guest]

Marius,I have found these forms from the Division of Immigration Health Services to be helpful as an exam template according to age. However the immunizations sections may not be up to date.http://inshealth.org/Forms/forms.shtm#PFI usually only do vision and audiometry checks when they are required to enter school. I purchased a Welch Allyn Audioscope 3 audiometer for about $600 just because I wanted to have one for school physicals. I can't say I have made any profit with it, but sometimes you just need to have it to do what you need to do, like PPDs. You can get a Snellen eye chart from any medical supply place (about $15), or you might consider Ebay? SetoSouth Pasadena, CANext week, I am going to do my first well child checks (3 and 7 yearsold). I wonder: what HAS to be part of a well child check other than anormal H & P? Do I have to do audiometry or vision checks? If so, anyrecommendations for an audiometer and where to get a large Snellen card? Also, I am open to suggestions as to other interesting activities thatIMPers include in their well child checks (such as playing games etc.).Thanks, Marius

[Guest guest]

I forgot about BrightFutures. I found even better templates from the BrightFutures.org site:http://www.brightfutures.org/healthcheck.html SetoSouth Pasadena, CAMariusif you are using IMH, it has a reasonable WCC history, however, not quite as good as the one that you can do. Good for populating the note though.Agree with below.Also use BrightFutures.org for handouts for anticipatory guidance-  download and hand out- tip from ?Gordon- someone on the list serve.LynnTo: mllaumans; From: jantonuccifchn (DOT) orgDate: Sun, 23 Sep 2007 19:07:35 -0400Subject: RE: What is part of a well child check4 parts ot a wcc-hx inlcuding nutrition who is in the house smoking in the house familystatus etc illness injury etc -milestones i like the 4 yr old one the bestw hen i get to ask them to drawMom or dad and have to count bosy parts- 4 to passspeech walking etc-exam least important-anticpatory guidance don 't eventhink about having sex til you are 28etcthen immunizations and any screenign labs like lead etcThere are stadnard templates for each Mine came form teh state What is part of a well child checkNext week, I am going to do my first well child checks (3 and 7 yearsold). I wonder: what HAS to be part of a well child check other than anormal H & P? Do I have to do audiometry or vision checks? If so, anyrecommendations for an audiometer and where to get a large Snellen card?Also, I am open to suggestions as to other interesting activities thatIMPers include in their well child checks (such as playing games etc.).Thanks, MariusMake your little one a shining star! Shine on!

[Guest guest]

I looked it up, epsdt did not ring a bell though I must have heard it before. Here are some nice templates from Michigan. http://www.healthteam.msu.edu/imc/EPSDT/Toolkit_Contents.htm I didn't find any for CA. LonnaDr Levin wrote: Look up "epsdt" -- these are national standards. Did you not get training to know what are the

standards? FP solo in Western PA What is part of a well child check Next week, I am going to do my first well child checks (3 and 7 yearsold). I wonder: what HAS to be part

of a well child check other than anormal H & P? Do I have to do audiometry or vision checks? If so, anyrecommendations for an audiometer and where to get a large Snellen card? Also, I am open to suggestions as to other interesting activities thatIMPers include in their well child checks (such as playing games etc.).Thanks, Marius

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[Guest guest]

Thanks for all the answers. In retrospect, my question actually

sounded a bit too naive. I did residency in a program that had its

focus on OB and pediatric care so I am well acquainted with the

general structure of a well child check. We overdid it, though, and

basically did audiometry on everyone that had ears and vision checks

on everything that looked like an eye.

With my questions, I was aiming at these more special maneuvers such

as audiometry, vision checks, games etc. This part was well answered, too.

Thanks, Marius

>

> Next week, I am going to do my first well child checks (3 and 7 years

> old). I wonder: what HAS to be part of a well child check other than a

> normal H & P? Do I have to do audiometry or vision checks? If so, any

> recommendations for an audiometer and where to get a large Snellen

card?

>

> Also, I am open to suggestions as to other interesting activities that

> IMPers include in their well child checks (such as playing games etc.).

>

> Thanks, Marius

>

[Guest guest]

As I have limited space, I have one Snellen chart. You can get them for both 20 and 10 feet. I have the one for ten feet and for pre-kindergarten with pictures, not letters, and everyone, including the adults use it. You need it for DOT physicals also. I screen for color blindness for DOT physicals on my computer by using http://www.toledo-bend.com/colorblind/Ishihara.html. By having an area where the kids can play while you're talking to their parents, you can check off most if not all the appropriate developmental milestones. I also have a huge chalkboard, used for me to draw pictures for education, entertainment, and yes, for kids to draw their parents with green or purple chalk. Testing for hearing...whisper 'You can pick a toy out of the basket to take home if you clean up the toys now'. Multitask, multitask.

-- Lynette I Iles MD 214 South Iowa Ste 3 Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

Lynette,

Thanks for the color blindness link. I wasn't able to find a

reasonably priced chart to use. Free is even better, with the

understanding that it is only screening.

Sharon

At 05:41 PM 9/24/2007, you wrote:

As I have limited space, I have

one Snellen chart. You can get them for both 20 and 10 feet. I have the

one for ten feet and for pre-kindergarten with pictures, not letters, and

everyone, including the adults use it. You need it for DOT physicals

also. I screen for color blindness for DOT physicals on my computer by

using

http://www.toledo-bend.com/colorblind/Ishihara.html. By having an

area where the kids can play while you're talking to their parents, you

can check off most if not all the appropriate developmental milestones. I

also have a huge chalkboard, used for me to draw pictures for education,

entertainment, and yes, for kids to draw their parents with green or

purple chalk. Testing for hearing...whisper 'You can pick a toy out of

the basket to take home if you clean up the toys now'. Multitask,

multitask.

--

Lynette I Iles MD

214 South Iowa

Ste 3

Washington IA 52353

Flexible Family Care

'Modern medicine the old-fashioned way'

This e-mail and attachments may contain information which is confidential

and is only for the named addressee. If you have received this

email in error, please notify the sender immediately and delete it from

your computer.

Sharon McCoy , M.D.

Renaissance Family Medicine

The

Rebirth of Personal Healthcare

www.SharonMD.com

Phone Fax (949)

281-2197

IMPORTANT NOTICE REGARDING THIS MESSAGE AND

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you.

[Guest guest]

Okay. Make your own. Black symbols. 20/10 measure 6x6mm 20/20 measure 11x11mm 20/30 measure 17x17mm and so on. Sorry that I didn't think of just measuring them for you earlier. I had tried myself to find those measurements when I was looking, but no-one had a 10ft table, I wasn't even sure that a 10ft one was kosher, and my brain was so fried by then that $15 seemed cheap for having someone else make me one! I got mine from McKesson.

-- Lynette I Iles MD 214 South Iowa Ste 3 Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

I found this. Looks pretty goodhttp://www.utmem.edu/pediatrics/general/clinical/forms/wcc_forms/index.phpShirley Pigott MD

Texas

Okay. Make your own. Black symbols. 20/10 measure 6x6mm 20/20 measure 11x11mm 20/30 measure 17x17mm and so on. Sorry that I didn't think of just measuring them for you earlier. I had tried myself to find those measurements when I was looking, but no-one had a 10ft table, I wasn't even sure that a 10ft one was kosher, and my brain was so fried by then that $15 seemed cheap for having someone else make me one! I got mine from McKesson.

-- Lynette I Iles MD 214 South Iowa Ste 3 Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.