Preparing for the Visit
The usual advice you will be given on “how to get the most out of your pediatrician visits” is to make a list of your questions and to prepare your child for the visit:
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You can discuss with your child, appropriately for age, what the visit will entail.
- Read children’s books about visits to the doctor.
- Let your child play with some “doctor” equipment.
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Take along a favorite toy or book to pass the time waiting, which I hope is not too long.
These are all worthwhile suggestions.
However, the scenario often unfolds with your leaving the list on the kitchen table and your child beginning to cry upon your entrance to the waiting room or sooner. Do not fret: you are not a failure! It is just that doing the right thing does not always give you the result you want. Do the right thing anyway.
During the Visit
If you do forget your list, go organ system by organ system, body part by body part, and this will help you to remember. When the doctor asks about your concerns, be sure to ask all your questions at the beginning, so the doctor can ask you clarifying questions and make note of them while performing the physical.
It is never a good idea to hold a question until the end as a “by the way.” This prolongs the visit and is the principle reason the next patient has to wait. Sometimes, when there are multiple issues, the doctor may forget to look at that thing that was originally concerning you. Please remind him. Doctors are human, after all.
When the pediatrician enters, after the greeting and small talk, you should relate all the questions you have so they can be addressed. Be as specific as you can be, using objective or measurable terms whenever possible.
For example, instead of saying “Jessie seems irritable lately,” you may want to say, “Jessie wakes up from his naps crying, which lasts for about 30 minutes. He has done this at least 5 days a week for the past 2 weeks.”
List all medications your child is taking.
If your child is ill, relate the symptoms, severity and duration.
If your child cries
Most children who cry at “the doctor’s” do so because they are apprehensive about what “they“ are going to do to them. Before beginning the examination, the pediatrician should spend some time developing a relationship with your child through play, patter, and a light touch.
Once the crying begins, I find it counterproductive to actively try to get the child to stop.
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If distraction and reassurance do not work, then just treat him/her as if he/she is not crying.
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Once the doctor finishes the necessary actions, the crying will usually stop. In this way, the apprehension will diminish and he/she will be less fearful the next time.
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Allowing your child to sit on your lap during the exam goes a long way to alleviate such nervousness.
The Doctor’s Advice
Listen to whatever advice is given and don’t hesitate to ask for further explanation if you don’t understand.
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It is often a good idea to write down what the doctor tells you, especially if you have a specific concern, if the issue is complicated, or the explanations and suggestions are long or confusing.
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You can also repeat the instructions to be sure you understand them, or ask to have a written copy.
Remember that your child’s well-being is paramount to the pediatrician and s/he will advise what s/he believes is the best for your child. However, remember that medicine is not an exact science. Opinions can vary among physicians. Ask 5 doctors a question and you are likely to get 10 answers. You can always ask the reasoning behind the advice and if there are any alternatives.
Do not leave the office confused. It is the doctor’s responsibility to make everything clear to you and it is your responsibility to question us and ask for further clarification until you are sure you understand what the doctor is saying.
As children become older, they can participate in this process. They can describe symptoms, ask questions and participate in the decisions regarding their treatment. After all, they are the patients.
Handling Information from the Internet
Be aware that most of the information that you receive over the internet is questionable, unless it comes from a reliable source like the American Academy of Pediatrics web site. Feel free to discuss this information with your provider as a positive discussion of the relative merits of the information.
If there is a condition with which you are not familiar, ask for an explanation and write down the diagnosis. You can research it later, remembering what I said before about the internet. Ask the provider if there are any handouts so you can read them when you return home.
What you do get out of your visit directly relates to your and your child’s relationship with your provider and your confidence in him/her. It is good to question decisions, but not in an adversarial manner. Remember that our goals are the same: to do the best for your child. Make every visit a learning experience – just as I do!
By Joseph Cirotti, MD Department of Pediatrics Abington Hospital – Jefferson Health
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