Therefore, being able to consult effectively with children and their parents is an essential skill.
- Assessment of the child begins when they arrive, with body language giving many clues. Look for signs of pain, anxiety and shyness. Establish a rapport from the beginning, both with the child and the adult attending with them.
- If the child is old enough ask them to contribute when gathering the history, using appropriate language.
- A box of toys and books can be fun and offer distraction, putting the child at ease and allowing the adult to speak more freely.
- Consider safety issues, such as where the sharps bin is located.
- Children are inquisitive and seek these things out if they are in easy reach.
- Assess the child's level of comfort while in the room. Smaller children are usually more content when examined on the lap of a parent.
- Sit at the child's level, give lots of eye contact and give praise throughout.
- Role play, such as listening to teddy's chest, may help with co-operation. Leave potentially upsetting parts of the examination until the end, such as ears and throat.
- Discuss the management and be specific about review dates if the problem is not improving.
- Provide information as to what to do if the condition changes significantly, including out-of- hours.
- Registrars may not know the family so speaking with other GPs, the health visitor or school nurses can be useful.
- If unsure clinically, speak with your trainer or ring the on-call paediatrician, they are often very helpful and supportive.
- Consulting with adolescents may involve dealing with sensitive matters, such as contraception, STIs and acne.
- Patients may also worry about confidentiality issues. If they attend with a parent, the option of consulting with or without the parent should be suggested.
- The GMC guidance 0-18 years: guidance for all doctors gives useful information on consulting with children of all ages.
- Dr Karen Snowdon is a GP registrar in Northumbria