ONLINE EXCLUSIVE: So you want to be a camp doctor?

Nurses and physicians who specialize in chronic medical conditions usually lead medically supervised camps for children with those illnesses. Although these subspecialists are experts in their specific fields, there is still a need to provide comprehensive care. General pediatricians are experts in caring for the whole child and looking at the big picture of children's health care. This perspective allows them to be attentive to all the children's needs, whether they are healthy or have chronic medical conditions. General pediatricians also are accustomed to coordinating care and collaborating with specialists. At camp, pediatricians work directly with not only the specialist affiliated with the camp but also the children's own pediatrician or other specialists when the children are ill.

How do I find a medically supervised camp?

There are several camps available for children with chronic illnesses and other medical conditions (ie, bleeding disorders, sickle-cell anemia, HIV/AIDS, cancer, diabetes, epilepsy, dialysis, asthma, ventilator dependent, heart disease, arthritis, transplants, burns, autism, attention-deficit/hyperactivity disorder, cerebral palsy, neuromuscular conditions, developmental disabilities, physical disabilities, and sensory and language impairments). Because most specialty camps are affiliated with nonprofit foundations or children's hospitals, you can find their camps by calling them or looking up their Web sites. You can also search for medically supervised camps on the American Camp Association Web site ( http://www.acacamps.org/).

The camp director who oversees all camp activities and the camp staff organizes camp. The camp director does not need to have a medical background.

There is a camp health officer who is usually a nurse. This person ensures that camp is in compliance with state camp guidelines and that medical policies are current and complete. The camp health officer should review campers' health appraisal forms and speak with all the camper's parents to review them. This person is responsible for ordering medical supplies and medications; identifying local pharmacies for prescriptions, local hospitals for emergencies, and the county public health department for reporting communicable diseases; and communicating with emergency medical services (EMS) regarding their response time to camp and level of care they are able to provide. It is recommended that this person also work closely with the Association of Camp Nurses.

The medical director works in close collaboration with the camp health officer to ensure that campers have a safe camping experience. The medical director reviews the medical policies and protocols each year and oversees the medical staff. Most camps primarily employ nurses, but at many camps, the medical staff includes nursing and medical students, residents, fellows, general pediatricians, and specialist physicians. The medical director will often consult with pediatric subspecialists, pharmacists, local emergency department (ED) physicians, and public health officials as the need arises. This person speaks with the children's pediatricians and parents to provide the best care when the children are ill. The medical director should be at camp as often as his or her schedule allows. When not at camp, the medical director should be available by phone or pager 24 hours a day.

Are there educational opportunities at camp?

Some medically supervised camps are affiliated with medical schools and residency programs. This relationship provides a wonderful opportunity for pediatricians to teach medical students and residents in a setting outside the hospital or clinic. In turn, pediatricians are also able to learn from nurse and subspecialist expertise in the medical conditions of that particular camp.

Education is of utmost importance for the campers. Most camps focus on teaching the children about their medical condition so that they have the tools to understand their illness, thereby developing confidence and independence. Their experiences at camp have a tremendous and lasting effect on the children's social, emotional, and physical well-being. After camp, many children take more responsibility for and are more invested in their health care.

Campers provide the medical staff a unique perspective on chronic medical conditions.¹ While in the hospital or clinic, physicians usually spend limited time with each patient. In contrast, at camp, the medical staff is able to see what life is like for a child with a chronic medical condition 24 hours a day. The children are able to teach the medical staff firsthand about the daily struggles they face because of their illness-from dietary restrictions at meal time because of food allergies to deciding to take off their wigs in front of everyone in their cabins to performing venipuncture on themselves to administer factor. The medical staff has endless opportunities to learn.