British Researchers
Show Chiropractic
More Effective

DR. ROBERT LEVINE
AND
DR. STANLEY LEVINE

"Patients with back pain who go to
a chiropractor do better than those
treated in a hospital, says a report.
They suffer less pain and need few-
er days off work. Wider use of the
treatment could save the country
millions of pounds in lost output and
social security payments, it is
claimed." — Clare Dover, Medical
Reporter, Daily Express

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Growing Pains

JILL DAVIDSON SKLAR STAFF WRITER

I

t happened the other day.
I was sitting in my son's
pediatrician's office, wait-
ing to see the doctor,
when a tall, handsome boy
came.throughthe door, trailing
his mother by several paces.
Distancing himself from any
possible recognition that he
could be related to the
woman with him, the boy -
found a small, brightly painted
chair a good 5 feet from
where his mother sat. As tod-
dlers in the waiting room
groped the fish tank and
pawed at the exotic creatures,
he let out a sigh.
"I don't know Why I can't
go to your doctor," he grum-
bled in a low voice. "This
place is for little kids."
In those few words, the boy

`This place

is for little kids.'

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spoke to the rite of passage
that children make as they
pass through the pediatrician's
office and on to either an ado-
lescent or adult medicine spe-
cialist.
The American Academy of
Pediatricians suggests that per-
sons under age 21 see the
doctor at least 28 times. Half
of those visits should be made
by those under age 6, mainly
to check growth progress and
receive vaccinations. This,
combined with the fact that
younger children are immuno-
logically less equipped to stave
off illnesses than their older

counterparts, helps to boost
the population of tykes over
teens in pediatric waiting
rooms.
That is not to say that
teenagers do not need the ser-
vices of a doctor, said Dr. Stan-
ford Singer, a local physician
with pediatric and adolescent
medical practices in Farming-
ton Hills and Southfield.
"When you get into adoles-
cent medicine, you face issues
including sexual growth, de-
velopment of peer relation-
ships, substance abuse, a
different level of peer and fam-
ily interaction, a different level
of school concerns and the
new challenges that come
with increasing indepen-
dence," Dr. Singer said.
"In the approach of the
physician, you don't sit down
and say, 'Is he walking yet? Is
he eating finger foods?" he
said. "You have a different set
of questions regarding their de-
velopment."
Pediatricians can handle
those concerns just as well as
those regarding cradle cap and
diaper rash.
"Anyone who has trained as
a pediatrician should be able to
take care of any person until he
or she is 21," Dr. Singer said,
adding that future physicians in
pediatrics are required to work
in the sub-specialty of adoles-
cent medicine as part of their
three-year residency.
Dr. Singer, a board member
of the American Academy of
Pediatricians, acknowledged
that this philosophy does not

fit all patients. Some pediatric
patients have built a rapport
with their doctor and will re-
turn from breaks during col-
lege for a consultation.
Others, yearning to break free
of the toddler-filled waiting
rooms, may seek a referral.
"It all depends on the com-
fort level of the patient," Dr.

Singer said.
He added that parents
should have a role in their
child's passage from pediatri-
cian to adolescent- or adult-
medicine specialist.
"The first item is to involve
the patient in the decision. It
is appropriate that parents dis-
cuss with their children any
concerns they may have," he
said, suggesting parents start
with a question like, "Are you
comfortable seeing Dr. Jones?"
Next, if a child wants to
change doctors, discuss with
the pediatrician possible refer-
ral choices. Finally, help the
child to choose his next pri-
mary physician, allowing him
the responsibility of a health-
care choice. ❑