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More Than Just Your Baby's Doctor

  • In another installment of our Newborn Screening Professionals blog series, we learned from the perspective of a primary care pediatrician who serves children with special needs. Dr. Tracy Trotter leads a private practice in Northern California where he plays a fundamental role in caring for special needs children and coordinating their care to a wide array of medical resources.

    Dr. Trotter pursued a career in primary care pediatrics and medical genetics out of the encouragement of mentors throughout his years of schooling and residency. His fascination in the subject and support around him motivated Dr. Trotter to pursue this career. However, genetics was only in its infancy when he began his practice. There were very little diagnostic and therapeutic developments in the field, so he remained a traditional pediatrician. But his expertise quickly transformed his practice into one that supports children with special needs.

    While about half of his patients are “routine”: kids with typical health issues, the other half has special needs. Of that half, about two-thirds have a genetic-basis to their healthcare needs. Some of the most common conditions he sees among patients are: Down syndrome; newborns from intensive care units with special needs due to premature birth, brain bleeds, or congenital or neonatal infections; and children with learning disabilities. But, he is seeing more cases of metabolic disorders due to better and more expansive newborn screening and diagnosis.

    Beyond caregiving, one of his most critical roles is the “behind-the-scenes” work of coordinating services and advocating for his patients. For example, many tests ordered for his patients are special genetic tests unfamiliar to insurance companies, let alone something they are willing to pay for. Outside of direct patient care, Dr. Trotter spends time researching the tests, writing proposals, and testifying on behalf of his patients, or as he calls it: “due diligence to plead the case.”

    While most of his patients do not come to him as a result of newborn screening, Dr. Trotter calls newborn screening a “great example” and “excellent starting point” in increasing awareness of innovations in medical genetics among health care providers. Primary care pediatricians are an infant’s first point of contact in genetic testing and the coordination of care. But so many of them do not even know that the newborn screening test they are ordering is a genetic test. As awareness among primary care pediatricians grows, they can help families best understand the health of their child and the next steps to coordinate care.

    Though the work is challenging and often “frustrating” there is nothing greater than the “emotional reward” he gets out of caring for children with special needs and supporting their families. Kids he has cared for since infancy are going to college, getting married, and caring for children of their own. After about 30 years in private practice, Dr. Trotter is at a point where can he see “the end result of the full experience.”

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