Back to School, Back to the Doctor

No matter what grade your child is about to enter, there’s the yearly back-to-school checklist of to-dos: shopping for school supplies, filling out permission forms, and the pediatric checkup.

While it may not seem as urgent, a yearly physical exam by your family’s pediatrician is an important part of your child’s health care. The back-to-school season is a convenient time for putting the exam on your family’s schedule.

Beyond the Athlete’s Physical

“Back-to-school checkups are often the only visit most kids and teenagers have with their doctor every year,” says Paul Stricker, M.D., FAAP, and author of Sports Success Rx! Your Child’s Prescription for the Best Experience. “The annual physical gives the pediatrician a chance to give the child a thorough physical exam. It’s also a good chance to address important questions, especially with teenagers, including adolescent issues of drinking, smoking, drugs, sexual activity, and depression.”

Children involved in school athletic programs often receive a sports-specific exam through the school. These exams are good at screening for potential athletic health problems. But Stricker points out that the school sports physicals alone tend not to address the child’s overall health.

“The mass school physical can certainly provide a quick identification of immediate danger to a child in relation to the child’s participation in sports,” he says. “But it is not a substitute for a general physical performed by the family pediatrician. Mass physicals are not as detailed or in-depth as a pediatrician’s exam. Of course, there’s nothing wrong at all with the child having both a pediatric exam with the family doctor and the school-sponsored sports exam.”

Building a Medical History

Stricker reminds parents that the school sports exam doesn’t get into the detailed medical history that the pediatrician knows. “The continuity of regular physical exams is invaluable,” Stricker says. “Having a long-term history with a child or adolescent gives the doctor the awareness of the child’s progress and development over time. This helps the doctor detect emerging problems, as well as being informed by the detail of the patient’s history, such as important past illnesses or injuries the child may forget to mention on the sports physical questionnaire.”

That detail includes immunization records. “A school exam will generally include a check box asking whether all vaccinations are up-to-date, requiring the parents to remember whether or not they are. The family pediatrician will have accurate records.”

Total Teen Health

Adolescence is a time when vital changes are taking place. “It’s important to have your child see the pediatrician during the transition years from later childhood to puberty,” Stricker says. “That is in terms of both development and the aches and pains your child sometimes feels. It also provides the pediatrician a sense of your child’s level of self-esteem and emotional balance.”

The annual pediatric exam also offers the doctor time to provide wellness guidance and advice. This has become critical as the nation wrestles with the childhood obesity epidemic. “Certainly pediatricians are paying more attention to obesity and related issues,” Stricker says. In addition to monitoring heart and blood pressure and testing for diabetes, pediatricians can use this annual visit with your child to discuss diet and exercise options.

“We can talk with the child and the parents about safe approaches to transitioning from little or no exercise to a sound, achievable exercise program,” he says.

Examining the Young Athlete

The other side of the exercise issue is the student athlete who is already involved in an exercise and training program. “Overuse and overtraining injuries are huge problems,” Stricker says. “They’re on the brink of becoming a national epidemic nearly as large as obesity.”

The doctor’s annual exam of a young athlete should be similar to one for any other child, Stricker says. But he adds that most pediatricians will address some sports-specific issues, including injuries, nutrition, training and exercise programs, and even attitudes in the course of the exam.

“Sports can improve a child’s self-esteem,” he says. “But they can also harm it. If there’s too much pressure, if there are brewing emotional issues, if the child is involved in the sport because of parent or peer pressure — anything like this can become an issue that affects the young athlete’s well being.”

Getting the Balance Right

Stricker is quick to point out that those issues are not limited to children involved in athletics. “Whatever the child’s interest — sports, academics, the arts — we want to be sure that the interest is a healthy one, and that it’s balanced with the other aspects of the child’s life.” A healthy childhood and adolescence calls for balancing home life, school, social activities, sports, and extracurricular pursuits. This is not easy, especially during a time when the child is passing through the years of growth, learning, exploration, and emotional and physical development. Which is all the more reason to set aside one day during each of those years for your child to see the pediatrician.