I see this as a problem in medicine and every field...
We seem to have gone into a speciality after medical school -- but even during our training we were siloed. We did and were graded on our "performance" in gynecology, in pediatrics, in psychiatry, in neurology, in surgery, in internal medicine... etc....
However a person is not siloed.
A person is a person..... as an example the patient is a person who becomes pregnant but also has a seizure disorder and is 14 years old who by the way happens to develop "psychotic depression" and then gets appendicitis (who's pregnancy was conceived by her father and she doesn't want anyone to know), pretty complicated to decipher who this "kid" belongs to...
Is it peds/ob/fp/im/neurology/surgery/ social work???? Bottom line, all of us need to be involved!!!! The problem is we aren't all involved. Often times we look and think "is this my patient or the neurologist's now?" Seen it all the time in medicine and I bet others have too....
When I worked in Rochester, MN I had several mom's who had been my patients and they were still teens. Our policy was "you had a baby, move on to IM or FP" even if the parent was only 14 years old. I broke the rules several times and the inflexible system didn't like that. I would see them both for colds (mom and baby)..... I didn't think and don't think these rules make any sense.. just because a 14 yr old girl gave birth does not mean she is not a pediatric patient..... at least not to me...
So it is all complicated..
I would love to continue to learn about how to make a hospital system trauma informed... am moving on to a new practice... where I will be the only ped .. so I get to decide.......
So thanks for all the information and learning.....