Okay, so clearly, I'm just a second year med student, and I'm not even remotely saying I'm ready to make clinical decisions on my own. So... I'm really just anticipating. Here's the story.

Son (1 week from 5th birthday) gets sent home with "a rash." He's had extremely dry skin, so I wasn't worried, and even brought along lotion. I looked at the rash, and using my limited knowledge, figured it was probably nothing (with reasonable reasons), especially since I could barely see the offending rash, and the redness from his scratching had gone away. (He's an itchy child in the winter. I need to be better about lotioning him.) Anyway, so he needed to go home till he could get a physician note saying he's fine. Sigh. So we had to trudge up to the pediatrician who did the exact same exam as I'd just done, and pronounced him fine. (Meanwhile, the rash had become nearly invisible, and I felt silly even being there.) Really, I'm only upset from the time it took, and the copay. It felt nice that my H&P skills are coming along where they should be at this point in my education.

But here's the question: once you're an actual physician (particularly if you're a pediatrician), if you get a call like this do you just get snarky and say "I am a physician; he's fine." or do you make the same trek as I just did up to the pediatrician? I'm *not* suggesting treating one's own child; clearly that's a bad idea. But it does seem reasonable to do some triage. (And, if so, how do you avoid sounding snarky?)

I generally try to explain WHY they're fine. (no fevers, not oozing, not blisters etc.) I find that the day care teachers are more willing to accept an explanation than a yes/no answer.

Granted I'm not a pediatrician, but I still take my kids to their doctor though I'm probably less apt to rush them to doctor than my non-medical friends who share the same pediatrician. From personal experience, I've learned it's best just to be their mom. I can't be as objective if it's my family/child. Growing up, I rarely went to the doctor except for annual visits/vaccinations as my father was a doctor and I survived childhood (broken hand for three days before I got xrays and a cast, etc). Probably different if you're a pediatrician or family medicine doc though.

Honestly, once I finished medical school, I didn't get any more questions from my son's school regarding him being there or not. I think they assume that I won't send him there if he's sick.

I had this exact scenario a couple months ago. I told them it was nothing. They told me a doctor besides me had to write the note. We took her, got note, back to school. They do let me sign for meds to be given, though.

I am a pediatrician, and although I do not provide well child checks or significant sick visits for my own kids, I do not hesitate to call in refills, sign medication at school notes, etc. I bring home flu shots and give them to them at home. I have a very clear sense of when I need to have someone else see them and do not hesitate to bring them in to have my partners check them if there is something really going on. I do have a degree of guilt about that though, here I am on my day off, adding to my partners' workload!

I have always written notes for my kids to go back to school. I mean, it just needs to be a 'doctor's' note, right? I just say, "[Name] was ill [dates] and is released to go back to school on [date]." If they have questions they can call me--no one ever has. Really, who pays more attention to their health than me?

I think kpzr has a good point, though.. we definitely have a family doctor, to whom they go to if I am concerned at all. They get shots/well checks/sick visits with him when needed.

I no longer treat my children for their acute illnesses- ever since the time I prescribed an antibiotic my child was allergic to (it was her first exposure to it, so this was not foreseeable, but still...). My policy is now that I let someone else handle it, as the guilt was overwhelming.