How to be assertive with your child’s doctor

Taking your infant or toddler to the doctor can be scary for so many reasons. Doctors know more about medicine than you do, their directions seem so inflexible, and at most pediatricians nowadays, the wait before and after means that even if they’re not rushed by the time your sick little one gets seen, you are! Here are a few steps to help make sure that your child receives the best care, and that you’re on the same page as his doctor.

1. Keep a notepad for each child’s doctor visits. Write down any questions that you have in between appointments, to ask next time. If your child is sick, write down temperatures, symptoms, and the time and date that you noticed them. Write down any instructions you receive for medication, food steps, or other medical issues. With these notes, you can track your child’s wellness, notice patterns, and be sure you don’t forget the questions that you wanted to make sure were addressed.
2. You are your child’s parent, not the doctor. While the doctor may know best for medical advice overall, you are your child’s biggest advocate. You are with her day in and out, know his normal behaviors, and have the parental gut instinct. Not every doctor will catch an issue the first time around, and it’s okay to go back and get a second opinion, or make the doctor double check. My 13 month old daughter developed a fever, and her pediatrician checked her ears and said they were clear as a bell and beautiful. Later that day, we were still worried, and took her into the local ER. One medical student and one resident checked her ears and said she was fine, but wanted a chest x-ray to check for pneumonia. That came out clean, but they still passed us on to a senior doctor, who took one quick look in my daughter’s over-prodded, sensitive ears and said “Wow, there’s a raging infection, in both ears!” If we had not kept pushing, we wouldn’t have been able to treat or comfort her properly.
3. Be informed. Dr. Innessa Donskoy, Pediatric Resident at University of Illinois at Chicago, reminds parents to “be open to [doctor’s] suggestions.” Keep in mind, though, that they are suggestions. There’s nothing wrong with taking the prescription you were given and plugging it into Google, or asking your social network if they’ve had experiences with it before. Be an informed consumer. Make sure you follow up with your child’s doctor and/or pharmacist regarding any changes to their instructions, before you make the change—some changes recommended by homeopaths and old wives’ tales actually contribute to the weakening effect of some antibiotics—but it is important to be an educated consumer. As well, look up the vaccination list to know what your doctor will most likely be automatically recommending, or what may be required for day care. Here is the CDC’s list: http://www.cdc.gov/vaccines/schedules/
4. Be on time and prepared. We know, it’s not fair, you always get kept waiting anyway. But part of the reason is the 5- and 10-minutes late that some people, particularly in the beginning of the day, run for their appointments. The more on-schedule, or even early, you are for your appointment, the more fluidly the doctor’s (and thereby your) day runs! Make sure you have all required information, such as your ID and your child’s insurance card, ready for check-in, and that your child is wearing clothing that is easy to maneuver in for weighing, the stethoscope, blood draws/vaccinations, and whatever other procedures are scheduled for this visit. Also, Dr. Meghna Nayak of Newkirk Family Health Center says, “parents often have a lot of little concerns when they come in, but what we need to know is, what’s your main concern, what’s the one thing that brought you in today.” While the other concerns are, of course, important, it’s easiest for your child’s pediatrician to check for the immediate need when a parent can articulate it clearly.
5. Don’t bring them in on the first day. If your child is sick and has no or a low-grade fever, but is generally healthy, is keeping down fluids, has regular wet diapers or is regularly urinating, and is relatively good-natured, don’t bring them in to the doctor’s office! Attending pediatrician at Maimonides Medical Center in Brooklyn, NY, Dr. Ravi Saksena says, “Usually, these things are viral anyway and there’s not much we can do other than recommend over-the-counter medication for reducing the fever and pain. Bringing your child in on the first day of illness only exposes them and others to more germs in our waiting rooms.” It’s okay to wait out a cold with a few days at home and some chicken soup plus over the counter pain relievers, and not step foot into the pediatrician’s office. He does mention, however, that if breathing becomes labored, your child isn’t taking fluids or urinating, or you’re concerned there’s a medical emergency, skip the pediatrician entirely and head straight to the emergency room! And if it’s been a few days and you’re getting concerned, you can always call your pediatrician or schedule an appointment.
6. Keep up with physicals and well-visits. The best way to be able to be assertive with your child’s doctor, and a strong partner in your child’s care, is to develop a relationship with your child’s pediatrician. Bringing your child in for their physicals and well-visits is imperative in her ability to develop a relationship with the doctor (even if it’s a practice, and you don’t always see the same doctor), and, perhaps more importantly, “allows us to keep tabs on if the kids are meeting their developmental milestones and how their nutrition is going, helps us figure out how the child is growing instead of doing everything all at once when they come in sick,” says Dr. Nayak. Basically, bringing your baby in for her checkups helps the doctors to establish a “normal” for their patient!
7. Understand antibiotic use. Antibiotics only treat bacterial infections. Most colds and a number of ear infections are caused by viruses, which can’t be treated with amoxicillin or other antibiotics. It’s cold and flu season; most kids are going to catch a cold in daycare and most runny noses are caused by viral infections. If your baby has a fever with their runny nose, you should keep them home. But, if your little one’s daycare has a policy that, even in the absence of a fever, runny nosed kids must be on antibiotics to attend, DON’T go running to the doctor for antibiotics and insist on receiving them! They most likely won’t treat the cold, this contributes to antibiotic resistance, and many antibiotics have side effects like diarrhea, which can contribute to spreading of any virus. For more information on the over-prescribing of antibiotics, check out this WebMD article.

Written by Shoshana Rishon (c)2014  All rights reserved.