Wednesday, January 01, 2003
Building strong doctor-parent relationships
By Darcy Lewis
Parents have a litany of gripes about pediatrician. The office wait is too long. The return phone calls come too slowly. The pre-school check-up must be booked months in advance. Well, here's a little secret: pediatricians have gripes about parents, too.
Seeing the parent-pediatrician relationship from the doctor's point of view can go a long way toward making the relationship a healthy one. Consider these common scenarios.
Antibiotics all around? Jason has a fever, cough and sore throat, so you're off to the doctor to get that magic prescription to make everything better. Imagine your frustration when the doctor announces Jason has a viral infection and antibiotics won't work. You took time off work and dragged a sick kid into a crowded office where you waited for hours, only to leave without so much as a prescription?
No point in getting upset about this one. The doctor knows best. "Bacterial resistance has become a widespread and life-threatening problem, largely because antibiotics are overprescribed when patients don't want to leave empty-handed," says Lisa Markman, a pediatrician affiliated with Children's Memorial Hospital in Chicago. "I want my patients to respect me enough not to keep asking when I tell them antibiotics won't help."
Information, please Your pediatrician says he wants Monica to get ear ventilation tubes to combat her chronic ear infections. Everything he says makes sense, but by the time you relay the details to your spouse, you have new questions. You call the office and get routed to the nurse, who suddenly seems more a hindrance than a help. Is there a way to resume the dialogue with the doctor?
Yes, but before you do that, do a little homework. Research the topic on your own and write up a list of questions from you and your spouse. Then, call the office and request a phone conversation with the doctor. You may have to wait until office hours are done, or even the next day, but your doctor should call you back at his earliest convenience. An increasing number of physicians are now happy to answer patients' questions by e-mail. If that appeals to you, discuss it with him in advance.
"Part of being a doctor is to be a teacher to both children and parents," says William Rutenberg, a Long Grove pediatrician. "For complicated topics, I always expect parents to have questions and I want to hear them and be able to respond to them."
"As long as I'm here..." This is definitely not what most pediatricians want to hear, because it's often the prelude to a complicated topic that has nothing to do with that day's visit. "Parents need to realize that doctors have a set amount of time to see each patient, so not every issue can be discussed at every visit," says Markman. "If you've come in because your child has an ear infection, that is not the time to talk about his chronic headaches or your concern that he might have ADD."
Instead, parents should make an appointment for another office visit for a more in-depth discussion. Rutenberg says, "I love it when parents set up a separate consultation because it tells me they respect my time." He suggests both parents should be included during the consultation, by phone if necessary. Your insurance may cover consultations, so discuss billing with the office staff.
1-800-DIAL-A-DOC You just know Dylan has strep throat again and would love to avoid yet another office visit. You call the doctor to ask her to call in a prescription. What's wrong with this picture?
"What if that child doesn't really have strep? Or what if he is the one in 100 who has strep-related complications?" says Rutenberg. "The mom is probably right, but I need to see that child so I can sleep at night."
A dose of honesty Your pediatrician prescribed antibiotics for your son's latest ear infection. You know he's supposed to take them for 10 days, but he seems better after five days, so you stop the antibiotics and now his symptoms are back. Off you go to the pediatrician, who prescribes a stronger antibiotic believing the first one wasn't potent enough. Should you ‘fess up?
Absolutely, says Mark Rothschild, Rutenberg's partner. "If your best effort at following our advice for home care doesn't work, be honest about it. Please don't tell me you tried if you didn't," he says. "I won't judge you, but I need your honesty to give your child the best care I can."
In fact, a little extra honesty and consideration on both sides is likely all that's needed to keep your doctor-patient relationship running smoothly for years. Then you can both focus on what's most important: keeping your child healthy.
Darcy Lewis is a freelance writer who lives in Riverside with her husband and two boys, ages 3 and 8.