About Babies and Children
How to Get the Most From Your Pediatrician
By Dr.
William Sears
January 9, 2012
During my 32 years as a doctor, I've grown to appreciate that
pediatrics is a partnership between me and my patients. That's why several
years ago, when my two oldest sons joined our practice, I gave them the doctorly
and fatherly advice to be humble enough to learn from the parents of the babies
and kids they care for. Parents teach me how to be a better doctor and, in
doing so, play a huge part in making sure their children get the best I have to
offer. To do the same with your child's pediatrician:
Start off on the right foot. At your first visit, let her know that you're
seeking a high level of medical care. When Jim and Deborah, a couple who
were expecting their first baby, interviewed me as a prospective pediatrician,
the first thing out of Jim's mouth was, "Doctor, this is a well-researched
baby." From there, he politely drilled me with questions, including the usual
"What are your hours?" and "Are you always on call?" as well as more probing
ones, such as whether I had a lactation consultant on staff in case Deborah had
any trouble with breastfeeding, and how much time they could expect from me at
well-baby visits.
It was obvious that picking the right pediatrician meant a lot to them, and
they'd done their homework. Most doctors will deeply appreciate this kind
of approach -- and they also appreciate politeness. Even a few kind words
about their practice goes a long way in establishing rapport. And call me
old-fashioned, but I do enjoy getting personal notes from parents (or even the
kids themselves). In fact, I still have a letter posted on my wall from a
7-year-old who didn't like being examined. It reads: "Dear Dr. Bill: I'm
sorry I kicked you. I was having a bad day. Love, Isaac."
You're the Expert
Be the expert. As part of this doctor-parent team, your role is to be a
keen observer and accurate reporter of any worrisome changes you notice in your
child because you're the top expert on his body and temperament. My
favorite example of this involves a blind mother in my practice who brought her
baby to my office to check out a rash. Though I couldn't find anything
wrong with his skin, because of her persistence, I asked her to bring him back
the next day. Sure enough, when they returned, her infant had an obvious
viral rash covering his entire body. Because his mom was so used to the
normal feel of her baby's skin, she actually felt the rash the day before I
could see it. It's this simple: You're with your child day in and
day out, and no one else is as invested in his well-being. That's why it's
important to trust your instincts and never let the doctor dismiss your concerns
or observations.
Play doctor. Make sure you can clearly express what those concerns are.
Before going to the pediatrician's office when your child's sick, imagine you're
the doctor. Ask yourself what you (as the pediatrician) would want to
know: When did he become ill? How did it begin? Does it seem
to be getting better or worse? What home treatment have you given?
Write down the answers to these questions.
Do your own physical exam too. Undress your child and look her over from
head to toe. Make a bulleted list of all your worries. I love it
when parents get right to the point, pull out a list, and volunteer what they
think the problem might be. More times than not, they're right -- and I
value their natural ability to see subtle changes and hidden clues in their
children that I may not notice. Remember: The more information you
can give your pediatrician, the more likely it is that you'll leave the office
with the right diagnosis and treatment plan. But don't stop there.
In the same way you keep a record of your child's immunizations and illnesses,
make a "what works" list too. When prescribing advice or medication, your
doctor will rely heavily on what has worked well for your child in the past.
For instance, if he's deciding which antibiotic to give her, you might remind
him, "The first antibiotic you prescribed gave her terrible diarrhea, but the
last one seemed to work better."
Stick to the point. If your child wakes up with a sore ear and your
pediatrician manages to work you in between already-scheduled checkups (doctors
leave open short time slots for such spur-of-the-moment cases), don't try to
squeeze in a "doorknob" question. That's what I call those queries that
come at the end of an appointment, after I've diagnosed the problem, prescribed
treatment, and have my hand on the doorknob of the examining room, ready to
exit. Then a parent interjects, "By the way, Ryan's teacher says he might
have ADD. What should we do?" Complex medical problems don't have
quick and easy answers, and shouldn't be brought up during an impromptu visit
for an entirely different issue. Instead, schedule a more extensive
appointment for another day. To make sure you get enough time for an
in-depth appointment, tell the receptionist the nature of the problem and
request a longer visit, or ask if the doctor reserves certain hours or days of
the week for extended consultations. An insider tip: The first
appointment of the morning and the one following lunch are those in which she's
typically not running late or concerned about a full waiting room, so you're
likely to get a few extra minutes from her.
Nice and Comfy
Help your kids feel comfortable. Trying to examine a screaming patient is
difficult for everyone, so it's best if you can prepare your child for her visit
to the doctor. This way, the doctor will be able to make the best use of
his time while you're in the office. To help ease her mind, if she's old
enough, read a book about going to the doctor or role-play with her favorite
doll or stuffed animal. (You can even try bringing it along to the
appointment, and ask the pediatrician if he might first give Mr. Teddy Bear a
quick checkup.) Once there, greet the doctor with enthusiasm.
Mothers mirror the state of their world to their kids, so if you're
apprehensive, your child is likely to be too (this includes babies)! If he
clings to you like a little koala bear at the first sight of the doctor,
immediately put on your happy face and, rather than reinforcing his fear by
holding him tighter, loosen your grip. If from previous experience you
know what settles your child best, by all means, let your pediatrician know.
Even little things may help ease her tension. For instance, "Lauren,
really enjoys the exam better if she sits on my lap," or "Tommy would like to
listen to his heartbeat."
Tell it like it is. Like any relationship, the one between you and your
doctor may not always be perfect. But you don't necessarily need to find a
new pediatrician the second something she does (or doesn't do) bothers you.
If you want more from your doctor than she's giving, let her know. A
longtime patient of mine once wrote me a letter telling me she felt rushed
during her baby's exam. After reading it, I realized that since she seemed
like such an experienced mother, I'd assumed she didn't require that much time
with me. I was wrong, and the fact that she cared enough to speak her mind
motivated me to be more attentive to her needs. One of the most common
complaints that I hear from patients who've transferred to our practice is, "I
liked my child's pediatrician, but we just didn't agree on parenting styles."
If you have a doctor whose medical advice you trust, you might stick with him,
and try to explain to him why your chosen parenting method works for you.
Point out how well your child is growing and how well-behaved she is, and let
him know that you've researched your choices thoroughly. Once he
understands how important a particular issue is to you, and he sees how healthy
your child is, he may very well come to understand your perspective -- or at
least accept it.
Build healthy lives. Don't assume that whatever's troubling your child can
be remedied with a prescription for antibiotics; a doctor who relies too much on
pills probably isn't your best choice. Of course there are times when
antibiotics are necessary or are the best treatment option, but feel free to ask
whether there's an alternative.
Use the opportunity of well-baby visits to talk about things like nutrition,
mental health, family exercise, and hygiene, and ask the doctor to help you
develop a personalized health plan for your child -- specific day-to-day ways to
care for her unique body, with its unique strengths and challenges, be they
colic, asthma, food allergies, or obesity. Update him on each visit about
how the plan is going, and whether you've seen any improvements in your child's
health.
As I stroll around my office, I'm constantly reminded of the many children I've
had the privilege of caring for. But what comes to mind just as often is
the parents. Their confidence in me, and in their children and their own
parenting skills, has helped keep me on my toes. I wouldn't want it any
other way -- and neither should you.
Used with permission from the author
How to Get the Most From Your Pediatrician
Dr. Sears, or Dr. Bill as his
"little patients" call him, is the father of eight children as well as
the author of over 30 books on childcare. Dr. Bill is an Associate
Clinical Professor of Pediatrics at the University of California,
Irvine, School of Medicine. Dr. Bill received his pediatric
training at Harvard Medical School's Children's Hospital in Boston and
The Hospital for Sick Children in Toronto -- the largest children’s
hospital in the world, where he served as associate ward chief of the
newborn nursery and associate professor of pediatrics. Dr. Sears
is a fellow of the American Academy of Pediatrics (AAP) and a fellow of
the Royal College of Pediatricians (RCP). Dr. Bill is also a medical and
parenting consultant for BabyTalk and Parenting magazines and the
pediatrician on the website
Parenting.com.
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'Behold, I will bring them from the north country, And gather them
from the ends of the earth,
Among them the blind and the lame,
The woman with child and The one who labors with child, together,
A
great throng shall return there...And My people shall be satisfied with My goodness, says the LORD.'
Jeremiah 31:8, 14
~~~
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March 2013
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