Anne Norwood has spent over 30 years as a nurse practitioner in pediatrics. Since she first began her medical career, pediatrics has been her overreaching goal — a calling. She has worked at Johnson Health Center since 2006, a facility that has since grown by leaps and bounds.
“When I started in 2006, we had one building, and I was the 6th provider at family practice. Now we have seven different offices, and we have 62 providers in pediatrics, family practice, dental, OB-GYN, behavioral health,” she remembered.
Pediatrics is a complicated practice that cares for — obviously — children, but it also has the added complexity of interactions with parents. There is also the wide age range of care: from infancy to age 18. Each age comes with its own set of challenges.
“There’s a huge amount of knowledge to learn,” Norwood stated. “And I’m still learning.”
Pediatrics does have a built-in advantage in that children want to be well. “There’s definitely a natural tendency for the body to try to heal itself, especially in young ages.”
The nature of pediatric care has changed immensely over the years. Norwood takes pains not to assume the role of an absolute authority, but instead see herself as an educator — an educator who assesses the particular needs of the parents, child, and family as a whole. There is a lot of parent education and then adolescent education, as kids get older and take ownership of their own health.
Half of Norwood’s schedule is well-child visits, which includes gaining a sense of not just the child’s physical state but their mental health as well. And teen anxiety, she noted, “is through the roof.” Her role as a nurse practitioner is not to offer formal counseling to a young person with, say, anxiety or depression but to identify what’s going on and coordinate care with the behavioral health team.
There is a chronic shortage of child psychiatrists, which means she and her team are trying to get better and better at doing medication management of other emotional problems as well. This is an issue with all of primary care — not just pediatrics — which is learning to take on patients’ emotional and psychological well-being rather than automatically referring them out.
Attention-deficit/hyperactivity disorder (ADHD) has been a huge area of interest for Norwood — then and now. She estimates that around 8% of the kids she sees have ADHD, which falls under the domain of mainstream pediatric care.
“We’re very good at assessing that and managing it behaviorally and medication-wise.”
Autism is another area that Norwood is learning more about — both diagnosis and management.
The role of medicine has changed in many ways over the years, just as society has changed. And certainly in pediatrics, where the old model was that the doctor made unchallenged pronouncements. Pediatrics, as Norwood’s observations indicate, has become more holistic, more conscious of the need for emotional support, and follows — as best it can — the model of consensus.
But there is something extraordinary about caring for patients from infancy to high school graduation. That continuity is one of the more amazing facets of pediatric care. Young people are facing an enormous set of challenges and difficulties these days — social media, for one, has unanticipated repercussions across the board.
Luckily, there are providers like Anne Norwood doing their best to guide and help young people and parents both.
