Where Do I Go? Primary Care, Urgent Care or Emergency Room?

When a child is unwell, sometimes it is hard for parents to determine if a run to the doctor’s office is necessary. In this episode, we will discuss with Dr. Shannon Godsil the top reasons parents should call or take their children to the doctor and when it is necessary to obtain a referral to see a specialist.

Topic Breakdown

01:00 – Where To Go When Your Child Is Ill
03:33 – Types of Specialists
04:52 – When to Consult a Specialist
08:42 – Questions to Ask Your Child’s Provider


Gina Melton: I think one of the hardest things I see is when my kids are sick. I just hate to see when my kids are sick. And sometimes it’s hard to know — when they’re unwell, should you take them to the doctor? Should you take them to the ER? Should you take them to the emergency care room? I mean, it’s just hard to know when you have kids. So, knowing how to distinguish an ailment from a more serious disease is gonna help you keep your children safe and healthy. And good news: We have an expert here today to talk about just that.

I’m Gina Melton with the Just Kids Health podcast from Children’s Nebraska. I talk to the region’s pediatric experts just like we’re gonna do today about everything related to children’s health from medical issues to mental health — all to keep your child healthy, safe, and strong. So, just sit back and listen. Or if you wanna multitask, that is totally fine too.

Today, I’d like to welcome Dr. Shannon Godsil. Good to see you today.

Dr. Shannon Godsil: Good to see you.

Where To Go When Your Child Is Ill

Gina: Yeah. So, I know you are an expert in this area and I often wonder with my kids, what should I do? Should I take them to the emergency room? Should I take them to the urgent care? Should I take them to the doctor? So, let’s talk a little bit about that and what we should do as parents.

Dr. Godsil: Absolutely. So, I’ll tell you that this is really tricky, especially when you are talking about the age of your child. Because what can make it difficult is if you’re talking about an infant or a toddler. So, my biggest advice is to call your pediatrician. What’s wonderful about Children’s is that we have a 24-hour nursing line. So, even after clinic is closed, there is a registered nurse that can answer questions about, “Is this something that I need to worry about right now? Is this something that I can wait till to the morning or do we need to be taking our kid immediately?” Or even calling 9-1-1. So, I think that is where we wanna start.

Gina: That’s just so comforting to know that. Because when you have a nurse at your fingertips like that, I know it just makes me feel more comfortable because sometimes I just don’t know. Like if your kid has a — like my boys have had a sore throat before. Is it strep throat? Or, you know, where do I need to take them? Things like that.

Dr. Godsil: And I’ll tell you there are some things that I like to tell parents that would be more — you’d be more likely to take them to the emergency room. Especially, a pediatric emergency room where you have someone that is more well-knowledgeable when it comes to taking care of kids specifically. So, if you’re worried that your two-month-old or younger has a fever, they should be going to the emergency room.

If your child is unable to breathe, is not able to say certain words having difficulty breathing, we should be either calling 9-1-1 or going to the emergency room. If they have a fracture or if they have a laceration or a cut that is open, and it looks very, very painful — another thing that you should be taking them to the emergency room for. Last thing is if you’re worried about a head injury and they’re not responding — that is a really important time to take them to the emergency room as well.

Gina: I know we did just that with my son Parker. He got a little knocked out in football and we took him straight to the Children’s emergency room. So, I guess we did the right thing.

Dr. Godsil: Yes! Absolutely — which is perfect. And I think it’s so hard because parents, a lot of the time, will have that idea that “better be safe than sorry.” You know, I don’t have all these answers. And so, I really do think that if you’re questioning anything, it is always best to talk with your pediatrician or talk with one of their nurses to get an idea of where to go next.

Types of Specialists

Gina: Now, I know you’ve been doing this for a long time and it’s what you’ve always wanted to do, which is awesome because I feel like that about my job too. But what are the different types of doctors for children? What can we expect?

Dr. Godsil: Yeah. So, we’re really lucky here in the Omaha area that we have a lot of general pediatricians that are specifically taking care of kids. When you’re talking about the bigger community of Nebraska, you might have other doctors that are also taking care of children. Those include family practice doctors or doctors that are taking both care of internal medicine or older patients or children which is pediatrics. So, again we are lucky here at Children’s that we have 14 offices that have general pediatricians that are taking care of just kids. What we also have here in Omaha are pediatric subspecialists. There’s actually 15 pediatric subspecialties that are board-certified.

Gina: Wow.

Dr. Godsil: We’re lucky that we have all of them here in the Omaha area.

Gina: That’s amazing. Children’s is such a treasure because, you know, for that very reason. A — it’s specifically for kids. And B — we have so many great specialists here in this area.

Dr. Godsil: Right. We’re really lucky. So, we’re one of the few areas that here at our disposal we have every single subspecialty.

When to Consult a Specialist

Gina: Now, when do you seek a referral or consultation with a specialist?

Dr. Godsil: So, that can be difficult because depending on where you live in Nebraska, you might not have as easy access to a subspecialist. And so, if you’re also talking about the region of Iowa that we serve — that might be another area that might be difficult to have, you know, on-hand subspecialists. But I think the first place, again, to start is with your general pediatrician.

You want to bring up the concerns you have that either have been long going or something that maybe your pediatrician has started to work up initially with some labs or some imaging, and we’re still not finding answers. And so, that might be a good time to say, “Hey, do you think we should take the next step on seeking out a specialist?” And your pediatrician should be able to guide you to what specialist should be best for you. Because there’s some subjects that can kind of overlap. So, it can be hard as a parent to know which to go to. And I think as an adult, sometimes you think of all the adult doctors that take care of you. But it can be very different in the pediatric world.

Gina: I know when you’re parenting and I’m a parent — it’s hard sometimes because you think, “What if I’m bothering them?” You know, that’s like the typical thing.

Dr. Godsil: Yes. Totally.

Gina: Even all my friends say that. Like, I feel like I’m bothering the pediatrician if I call he or she.

Dr. Godsil: Yes.

Gina: What do you say about that?

Dr. Godsil: I will tell you from a personal standpoint that I love when a parent comes to me and says, “I’m concerned and I would feel so much better if we just reached out to a subspecialist.” Then a lot of the times, it takes that pressure off me too, so that I can get some help.

Gina: Sure.

Dr. Godsil: Because I feel like the best care comes with multiple team members. And so when you have not only your general pediatrician in your corner — but multiple subspecialists— that are all kind of giving us some answers, it is the best way to take care of a child.

Gina: Man, I feel like everybody just did a sigh of relief. All the parents out there went — oh, thank goodness. I know I just did just for that very reason because I think so many parents think that. But that’s a really good point. You’d rather them call you than be wondering about it.

Dr. Godsil: Yes. Absolutely. And I sometimes love when my parents just say, “I know that this might sound crazy but I would feel so much better if…” — and that helps me a ton. Because a lot of the times, I’m going through all these things in my mind of what to rule out. But sometimes it’s not the things that the parents are the most worried about. So, when you tell me what you’re most worried about and we can hit those — it’s a whole different ball game.

Gina: And I like the fact that all these specialists are at your fingertips. And it’s really just one call. Like you said — call your pediatrician, call your children’s pediatrician and they can direct you in the right area.

Dr. Godsil: Absolutely. And I’ve been so fortunate enough that I’ve been able to work and train under a lot of these subspecialists. And so, what’s really nice is that here in the Omaha area at the Children’s Physicians offices, the general pediatricians are very familiar with our subspecialists. And a lot of the times, like you said, it just takes a phone call from your general pediatrician to reach out to a subspecialist to say, “Hey, should we make an appointment? Are there some things that I should do in the office first? Or can I send them right to you in the next week or month?”

Gina: Right. And actually, they’re building a new Children’s Physicians right out by me.

Dr. Godsil: Oh great. Yeah!

Gina: So, I’m super jazzed about it.

Dr. Godsil: Yeah. You’re like, “Oh, yay!”

Questions to Ask Your Child’s Provider

Gina: Which is awesome. Yeah. It’s right there. What are some of the questions that as parents we should be asking our child’s doctor?

Dr. Godsil: So, that’s a tough one. Because, you know, it can be a lot.

Gina: Yes.

Dr. Godsil: Depending on what you’re seeing your provider for. But I’ll tell you — the most important things to do are to follow up with your well child care visits. So those are critical because those are the times that you can ask about your child’s growth, their development, their overall health. And so, I think starting there and making sure that you are going to your regular well child care visits, are gonna have a lot of those questions answered. Because as your pediatrician, we have all these checkmarks that we go through as we go through each of those visits. And so, it might trigger some questions that you have.

So, I think starting there by going to your regular pediatric visits is huge. And then the other times, to call out to your pediatrician is when you have concerns. Because even if you had your well-visit in the past six months to a year, if there’s something that’s really on your mind, I would rather us set up an appointment versus you worry about them or take them to different doctors or urgent cares or what have you. But let’s just have a sit-down visit, do an exam, and kind of talk through any of your concerns.

Gina: That makes a lot of sense. I try to do that once a year. I never knew when my kids were younger and before they were getting sports physicals every year.

Dr. Godsil: Yeah.

Gina: You know, fortunately, they were very healthy. And so I thought, should I go to this well visit? And I read up, and it says you should always take them because you just — you wanna see where their growth is, and all those milestones.

Dr. Godsil: Absolutely. I’ve had lots of parents that, again, didn’t realize that this was something we should be doing on a yearly basis even outside of that first two years of life. And so, I’ve had lots of parents that didn’t realize that maybe we weren’t meeting certain milestones. Or we weren’t staying along our growth track. So, I think it is really important that you do follow up with your pediatrician at all of those well visits.

Gina: And, of course, there’s so many great pediatricians right here at Children’s Nebraska.

Dr. Godsil: Yeah. I’m a little biased but yes. We are very lucky.

Gina: Yes, absolutely.

Dr. Godsil: Absolutely.

Gina: Dr. Godsil, so good to see you. Thanks for coming in today to talk about this.

Dr. Godsil: Absolutely.

Gina: I feel reassured already.

Dr. Godsil: Perfect.

Gina: And thanks so much for listening to the Just Kids Health podcast. Just remember to rate, review and subscribe. And for more information on how we can help your child, visit https://www.childrensnebraska.org and follow us on social media.


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