Question
Why do I have to take my child to see a psychiatrist? Why can’t we just be seen by our pediatrician for medication?

Answer
This is a very good question. In many cases, a primary care physician, such as a pediatrician, is able to appropriately monitor and adjust some medications that are normally used for emotional and behavioral reasons. In particular, pediatricians are often comfortable with managing medications is cases of “uncomplicated” ADHD. It would be important to discuss this with a primary care physician in order to assess the physician’s level of comfort in dealing with psychiatric medications.
At the same time, children and adolescents in the foster care system often present with very complex symptoms and difficulties. Many times a psychiatric provider has more experience in dealing with these difficulties, especially when there are concerns related to PTSD or mood related difficulties. For these reasons, child placing agencies and caseworkers often have policies or prefer that these children and adolescents be seen in a psychiatric setting.
So, the decision or need to use a psychiatrist can depend on the specific situation and need for specialty services. If a foster child has responded well to treatment, and is relatively stable, it is worthwhile to investigate the possibility of continued follow-up through the primary care setting.

Dr. William Holmes, M.D., is the Senior Medical Director of Cenpatico Health Care.  To submit a question about your foster child’s medical treatment, please email the question to askdrholmes@nfpaonline.org.