Pediatric patients benefit from phone visits as much as adults

March 16, 2021

Telehealth visits – especially phone visits – have been a saving grace for many of our patients, proving efficacy, and providing a glimpse of how we can continue to deliver high-quality care beyond the COVID-19 pandemic.

This model of care works effectively for our pediatrics patients, as well. Even with visits in-clinic, much of the time is spent talking, with the pediatrician listening to the child’s medical history or reviewing care instructions. Telehealth visits work the same: Parents or guardians help their children explain how they’re feeling and provide answers to developmental questions. All of this can be easily and effectively done during a phone visit.

“In many cases with our pediatric patients, care provided during a phone visit and care provided during a video visit are equal – one isn’t superior to the other,” said Dr. Michelle Aguilar, a pediatrician with Venice Family Clinic. “A phone visit is actually more accessible to our community because many parents don’t have the technology to support video telehealth visits anyway.”

In addition to technological limitations, many of our pediatric patients’ parents don’t have reliable transportation to get to our clinic at a moment’s notice. For a parent who doesn’t own a car, getting to an in-person appointment within a short time frame could be a barrier to timely care for their children. But if they call Venice Family Clinic with an urgent need for their child and there’s a phone visit available in the next 30 minutes, that’s easier to make happen. Want proof? While our pediatric visit no-show rate is 13% overall, it’s currently at just 3% for phone visits. We’ve even been able to bring some patients back into care whom we haven’t seen in over a year because of the ease of phone visits.

Dr. Aguilar said that many common issues, like colic, constipation and seasonal allergies, can be diagnosed and treated over the phone by simply asking numerous questions and obtaining a thorough history. And for some patients – including newborns who haven’t had vaccinations yet or children with respiratory conditions like asthma – limiting their exposure to viruses like the flu is preferable to having them travel to be seen in person when it isn’t absolutely necessary.

So how do telehealth phone visits work with pediatric patients? Dr. Aguilar provided an example:

She recently had a phone visit with a 10 year old for abdominal pain. She started the visit with the child’s mother and asked her questions to get the story from her perspective and observations. Then Dr. Aguilar asked the same questions of the 10-year-old patient. Based on what she heard, Dr. Aguilar then asked the mother to place her hand on her child’s abdomen in certain places to see if the child experienced any pains, asked the child if he could jump up and down without pain and asked him if walking made him feel better.

“Abdominal pain can range from something as benign as gas pain to an emergency like appendicitis,” Dr. Aguilar said. “I was reassured by the information I received that it wasn’t an emergency and diagnosed the pain as constipation, which we’ve seen a lot of during the pandemic due to poor nutrition and lack of exercise. I also told mom to look out for specific red flags to know when to seek urgent care.”

Dr. Aguilar can also accurately assess even the youngest of patients over the phone.

The parent of one of Dr. Aguilar’s newborn patients recently requested a phone visit for her baby, who seemed increasingly fussy and had some changes to his bowel movements. The child had a known milk protein allergy, and Dr. Aguilar had previously worked with the mother to eliminate dairy from her diet so she wouldn’t pass that allergen on to her baby through breastmilk. After getting a thorough history of the child’s condition from the parent, Dr. Aguilar identified the cause of the infant’s symptoms: the mother had stopped breastfeeding and didn’t realize the formula she had started giving her baby was cow’s milk based.

“I provided an equal level of care over the phone as I would have in a video or in-person visit,” Dr. Aguilar said. “My process and approach – my decision-making as a doctor – is the same, no matter the format of the visit. Being able to provide telephonic health care is both valuable and necessary. It has helped me and my fellow clinicians provide equitable access to health care for our patients, who are the most vulnerable people in our communities. It would be very unfortunate if we couldn’t continue to offer it after the pandemic ends.”