$Unique_ID{PAR00003} $Pretitle{} $Title{The Parent-Physician Partnership} $Subtitle{} $Author{ Editors of Consumer Guide Chasnoff, Ira J} $Subject{Parent Physician relationship Physicians Doctor Doctors pediatrician pediatricians} $Log{} Your Child: A Medical Guide The Parent-Physician Partnership Raising a child is a big responsibility, and it's always comforting to know that there's someone you can turn to when you have a problem. For advice on many of your concerns about your child, you can call on your own parents, your family and friends, other parents, or your child's teachers. But when it comes to your child's health, the person you need is a physician. CHOOSING A DOCTOR To get the best from your child's doctor, you must first select the best doctor for your child. A pediatrician is a doctor who sees only children. The pediatrician has had an extra three to five years of special training in the physical, emotional, and educational needs of young people. Your family physician probably has comparable training in terms of years of study, but this study has concerned people of all ages rather than just children. The best pediatrician you can find should, in theory, know more about the care of children than the best family doctor you can find. The most important thing, however, is that you should be able to get along with the doctor who is caring for your child. If you feel more comfortable with your family physician than with any pediatrician in your area, you may decide to have the family physician take care of your child, too. You know what's best for your child, so trust your own decision. Your child's doctor, who is a trained and experienced professional, should be a reliable and sympathetic source of information and advice throughout your child's growing years. Always remember, though, that the doctor is a medical adviser, not another parent. There are decisions about your child's well-being that only you can make, and a good doctor does not try either to make child-rearing decisions for you or to make you feel that you're not a competent parent. A good parent-doctor relationship is one in which each partner respects the other. How do you find a good doctor? If you are a first-time parent, the doctor who delivered your baby may be able to give you names of local physicians and perhaps recommend someone who is well thought of by other new parents. You may have a friend or neighbor with children who can recommend someone. If you've moved to a new area, consult a neighbor who has children, or call a local hospital or the state medical society. Professional organizations will not give you recommendations as such; they will give you names and expect you to make your own inquiries. However, a phone call and a visit to a doctor's office should be enough to tell you whether that doctor is right for you and your child. It is also a good idea to visit the doctor even before your baby is born to become acquainted and to arrange for your baby's medical care. WORKING TOGETHER Once you have found a doctor whose medical ability you trust, there are practical steps you can take to maintain a good working relationship between the two of you. For example, don't feel slighted if you don't always speak directly with the doctor when you call the office because your child is sick. In many pediatricians' offices, a professional nurse practitioner acts as the go-between in communications with the doctor. You can have the same confidence in the nurse that you have in the doctor. The nurse is a qualified medical professional in his or her own right and is well able to handle many of your questions. This means you don't have to wait for the doctor to get through with a patient before he or she can talk to you. Of course, if your child's condition does require the doctor's attention, the nurse will arrange to have the doctor talk to you on the phone or help you set up an appointment to see the doctor. Whether you talk directly to the doctor or to the nurse when you call the office, be prepared to give the following information: - Your name and the child's name. - Your child's approximate weight. This is important because medications are prescribed by body weight, and the dosage that is appropriate for a 125-pound teenager is very different from that given to a 25-pound toddler. - Your child's temperature. Whether the child is running a fever--and if so, how high a fever--is a clue to the child's condition. Use a thermometer to take the child's temperature. A guess based on flushed cheeks or a hot forehead isn't good enough. - Information on any illnesses the child has been exposed to recently. - Details of medications to which your child is allergic. - The name, phone number, and business hours of your pharmacist, so that the doctor can phone in a prescription if necessary. (Although the nurse can handle many of your questions and perform some examinations and medical procedures, only a doctor can prescribe medication.) Be sure to have a pencil and paper at hand so that you can write down any information or instructions the doctor or nurse gives you. When you call the doctor's office, you probably know whether you just want some advice on the telephone or whether you want to bring the child in to see the doctor. Tell the doctor or nurse what you have in mind--don't expect her to guess. If the doctor or nurse thinks that it's not necessary for you to bring the child in, you'll be told the reason for that advice. However, the decision is yours, and if you still want a personal consultation, you're entitled to insist. Another way to stay on good terms with your child's doctor is to plan ahead so that both you and the doctor know what an office visit is intended to achieve. A common cause of communication breakdown between parent and physician is the parent's complaint that the doctor was too busy, didn't answer questions, or cut the visit short. To avoid this, always tell the receptionist what the visit is for at the time you make the appointment. If you feel you're going to need extra time with the doctor, let the receptionist know so that enough time can be scheduled--in this way, neither you nor the doctor will feel rushed. When you see the doctor, do not confuse the issue by trying to get a complete update on other family members' problems in the course of one appointment. Let the doctor examine your child and deal with the reason you brought the child into the office. If you have other concerns not directly related to the present one, make an appointment to come back another time. ASKING QUESTIONS One of the things you will probably have checked out when you chose your doctor was his or her ability to use language you understand. Doctors, like specialists in any field, are so familiar with their professional language that they sometimes forget how confusing it is to other people. So if your child's doctor slips into medical jargon that you don't understand, ask for a translation. Don't feel uncomfortable about asking, either. You must know what the doctor's instructions are before you can carry them out, and it's part of the doctor's responsibility to make sure that you are fully informed about all matters that concern your child's health. Sometimes you may find that you understand what the doctor is saying--but you don't agree with it. In this case, don't hesitate to ask why the doctor has reached a certain decision, or what the alternatives are. If you still don't feel comfortable with the doctor's advice, don't argue. You may get the doctor to agree with your point of view, but this may not be in the child's best interests. If you and the doctor disagree on a diagnosis or a course of treatment, ask for a second opinion. This means going to another doctor and asking his or her professional advice on the issue. Your doctor may welcome this suggestion--or even make the suggestion before you do. A doctor may be hesitant to assume full responsibility for diagnosing and treating a difficult or unusual case. In such a situation, it is common to have two or more consultants working together to determine the best course of treatment. When you ask for a second opinion, your doctor should be able to suggest names of possible consultants. If you trust the doctor, you'll trust his or her choice of other professionals. If you don't, you'll be looking for another doctor anyway. It sometimes happens that when communication between parent and physician does break down, the only responsible course the parent can take is to find another doctor. HOUSE CALLS Many people who are now parents remember the days when doctors made house calls, and they wonder why doctors today don't make house calls. Your physician will probably tell you that many wrong diagnoses resulted from the old practice of examining sick children in their homes without adequate equipment. In the office, the doctor has a professionally set-up medical facility with the equipment necessary for an accurate diagnosis. So whether or not a doctor makes house calls--and most don't--should not affect your opinion of his or her competence. If you trust your doctor, and if you're confident that he or she will always be available in an emergency, you've made a good choice. COMMUNICATION A final word on the parent-physician partnership--and, again, it's partly a matter of courtesy. If your physician is taking good care of your child, express your appreciation--doctors like to be thanked, just like anyone else. However, if you're not satisfied with the health care your child is receiving, the doctor should know that, too. A physician's failure to please you may be due to many factors other than professional inadequacy. If you let the doctor know that there is a problem, he or she may be able to correct it. If not, your best plan may be to find another doctor. Remember that although the doctor is your partner in caring for your child's health, you're still responsible for deciding just who this partner will be.