Talking to Your Child's Doctor

en españolCómo conversar con el médico de su hijo

Your child's doctor can be an incredible resource when you have questions and concerns about your child's health, but finding time for regular checkups and sick visits may be a stretch for your already jam-packed schedule. The doctor may be overbooked and overscheduled, too, so making the most of your time together is important.

What are the best ways to communicate your concerns and questions? And how can you strengthen your relationship with the doctor who plays such an important role in your child's health?

The Doctor-Patient Relationship

Today, doctors are pressured to see more patients in less time and to spend less time with each patient. Insurance issues, such as the need for referrals, complicate patient care for parents as well as doctors and their offices.

The increasing complexities of the health care system mean that parents have to play a more active role in their kids' care. In the past, parents may have known far less about their kids' health, growth, and development. Now, health information is readily available online, in bookstores, and on TV, letting parents be more informed than ever before. This is good news, because parents who actively participate in their kids' health care help to ensure the best care possible.

In some cases, though, parents who do their own research may find incomplete or inaccurate medical and health information. Parents armed with stacks of printouts from unreliable Internet sources could find themselves at odds with a tense and frustrated doctor who doesn't have time to agree or disagree with each piece of information.

Another common problem that may hinder a good relationship with your doctor is unrealistic expectations or an unwillingness to trust a doctor's diagnosis or treatment of a minor illness. For example, many parents expect a drug or medicine for common colds, when a wait-and-see approach is often better. As a result, some doctors may feel pressured to give in to parental expectations for prescriptions or treatment, even when it's not necessary or in the best interest of the child's health.

Communicating With the Doctor

Open communication and reasonable expectations are the key to building a better relationship with your child's doctor.

What can you expect from your doctor? He or she should:

• help you monitor your child's health
• explain your child's growth and development and what you can expect
• diagnose and treat your child's minor or moderately serious illnesses
• explain your child's illnesses and treatment
• give you information about how to prevent injuries and keep your child safe
• provide referrals and work with specialists in the case of illnesses requiring special expertise

Your pediatrician, family doctor, or nurse practitioner can also help you with other children's health issues, including exercise, nutrition, and weight issues; behavioral and emotional issues; how to cope with family issues, such as death, separation, and divorce; and how to understand and seek treatment for learning disabilities.

Good communication is a two-way street. You can aid communication by letting the doctor know that you trust him or her to care for your child. It's good to ask questions, but let the doctor know that you want decisions, diagnoses, and prescriptions to be based on the best decision for the health of your child, not what's easier for you or makes you feel better.

You should also be as prepared as possible with details during your doctor visits. When asked how your child is doing, be ready to share any concerns or ask any questions. It's best to be specific. Be sure to tell the doctor details about symptoms — for instance, if your child vomited three times last night, had a temperature of 102°F (39°C), or is having diarrhea. This helps the doctor assess your child's condition more readily and accurately than if you just say that "my child is sick."

Consider jotting down your questions and concerns before the appointment so that you'll remember everything you want to bring up. And if you're worried about symptoms your child is having, mention them to the doctor even if he or she doesn't ask. Tell the doctor what you've tried to make the symptoms better and what worked and what didn't. The more information you provide, the better the doctor will be able to assess your child's health.

Tips for Building a Good Relationship

Make the most of your relationship with the doctor (and the doctor's office) by following these tips:

• Be informed, but don't overwhelm. The Internet is a tremendous tool that can help you learn more about your child's health and development, but it's unrealistic to expect the doctor to evaluate every health resource or breakthrough you find on the Web or see on TV. If you have a particular article that you'd like the doctor to review or comment on, mail, email, fax, or drop off the article well in advance of the office visit, giving the doctor plenty of time to review and do any necessary research. Keep these requests to a minimum, though. If you're looking for information on a particular children's health topic, talk to the office staff or a nurse about whether they provide informational brochures. Ask the doctor to recommend some reliable resources where you can get health information. Many practices now have their own websites that may have a lot of helpful information posted for patients and parents to view.
• Be focused during the visit. Avoid distractions so you can focus your full attention on answering the doctor's questions. Turn off your cell phone and leave other kids with a spouse, babysitter, or relative, if possible. Also try to stick to the reason for the visit — for example, don't use a sick visit to discuss behavior problems that may require an in-depth evaluation. Instead, schedule a separate visit and let the office staff know the nature of your child's problem so that a longer appointment time can be allotted.
• Follow the rules. Respect the doctor's time by arriving for appointments on time or a few minutes early. If you're unavoidably late, let the office know, and give at least 24 hours' notice to cancel or reschedule. Many office schedules are packed weeks in advance, so schedule well-child or non-sick visits early. You should also familiarize yourself with the office's payment requirements and your insurance company's co-pays and referral policy to make appointments go more smoothly.
• Follow up. Before you leave the doctor's office, make sure you understand what follow-up appointments, lab tests, or blood work your child needs. Take notes about any instructions so you don't forget them, and if you don't understand how to administer medication, ask the nurse or doctor before leaving the office. Communicate with the office, too, if the medication prescribed isn't working or your child develops worsening or additional symptoms.
• Save time by making time. In most cases, it's best if you or your partner attend your child's doctor visits. This is especially true for complicated issues like behavior problems. Relying on a substitute like a nanny or grandparent may mean that information or instructions may be misunderstood or miscommunicated by the time they get to you or that in-depth questions the doctor asks can't be answered.
• Use good judgment. Using the phone for questions about symptoms can save you and the doctor time and money, but don't abuse the privilege. Save non-urgent questions about your child's health and development for well-child visits. Many knowledgeable nurses or nurse practitioners answer phone questions for pediatric practices; use these medical professionals as a resource for non-urgent questions instead of demanding to speak with the doctor each time you call. Nighttime calls should be reserved for more urgent issues — remember, the doctor is at home when you're calling.
• Embrace new types of communication. If the practice uses electronic health records (EHR) with a patient portal, it may be a very convenient way to get answers for your non-urgent questions. You can submit your questions at any time of day or night and get responses from the doctor of office staff when they can address them. But be sure to check on the practice's policies about the use of email or the patient portal. And never use these forms of communication if you think your child may have an urgent problem — talk directly to the health care provider by phone if there's time, or take your child to the emergency room or call 911.

The stress of having a sick or hurt child can strain communication between doctors and parents, and the many issues covered in well-child visits may leave little room for your questions. But don't hesitate to ask your doctor questions, no matter how insignificant you may think they are. Many times, problems with your child can be resolved easily with the help of the doctor.

And don't be afraid to give the doctor feedback about your office visit experience, such as whether you felt rushed during the appointment or needed more information about a prescription or procedure. A good doctor will want to work with you to provide the best care possible for your child.