Child abuse pediatricians can help prevent tragedies

Regarding the review of Erie County Child Protective Services (“Panel on child abuse hears horror stories,” Nov. 15 News), one item seems missing from the review.

The review made it clear that there was tremendous overload of cases per worker and that this led to dangerous corner-cutting. However, nowhere in the article was there any mention of evaluation by a trained, experienced child abuse pediatrician in cases where such things as unusual bruising patterns appeared or other evidence of dangerous caregiver practices occurred.

I say a trained, experienced child abuse pediatrician because Child Abuse Pediatrics is now recognized as a legitimate subspecialty of pediatrics by the American Board of Pediatrics. Too often, a general pediatrician, family doctor or emergency physician may be asked to see and evaluate a child and make a decision without the proper experience and training.

A child abuse pediatrician not only recognizes patterns of abusive injury, but by his or her training is well-positioned to determine if apparent injury was accidental, (i.e. happened in the manner described by the caretaker), inflicted, or if it is the result of an illness masquerading as an injury. The role of the child abuse pediatrician is not limited to making diagnoses; it goes on to training child protection workers and supervisors to recognize patterns of abuse and setting up protocols for evaluation. This type of medical resource is necessary to prevent the “horror stories” heard by the panel.

I am no longer practicing, but have practiced as a child abuse pediatrician in New York, Connecticut and Kentucky.

Betty Spivack, M.D.