Parents: Good, Bad & Ugly about pediatricians

In My Humble Opinion
1

I’m curious (for a selfish reason) about what you like and don’t like about your pediatrician (or as in our case, out family practice doctor).

Here’s my reason. A friend of mine is about to begin his pediatric residency. He’ll be a good doctor, but he’s never been a parent, so he has no idea what it’s like being on the receiving end of his care. I’m hitting up other parents I know for their input, which I’ll compile and pass on to him in a nice document. It’s advice he can’t get any other way.

I think it will also make an interesting thread, so it’s not just for my benefit. But I thought I’d be honest in letting you know that (unless you object) I’d be passing your views on (preserving your anonymity) to a doctor-in-training.

What I like:

My doctor always asks “How’s it going” from my standpoint as a parent. Not how Cranky Jr is, but how I am feeling about things.

My doctor once said Cranky Jr. was “a joy to examine.” It’s not exactly a compliment I can take credit for (as far as this being some character trait I developed in him), but it gave me the warm fuzzies.

My doctor anticipates concerns down the road. Cranky Jr. met a lot of his gross motor milestones at the later end of normal, so fairly early on our doctor said it’s no big deal if he didn’t walk until later than 18 months. I was glad he said that, because Cranky Jr. didn’t walk until 17 months, and I was confident about it even when lots of other parents expressed surprise.

My doctor also always tells me what he’s looking for and why he’s doing the things he’s doing, like when they feel their hips and legs during that first year.

I like that he doesn’t try to give me parenting advice. Medical advice yes, parenting advice no, which is how it should be, IMHO.

What I don’t like:

I wish my doctor would recommend some good books about things. I am hungry for more info than he can give me in a 15-minute visit. I’ve found some great books on feeding, for example, that I just lucked into. I wish he’d offer some suggestions.

One time during a sick-kid visit one of the doctors in the practice said “Once you get more confident as a parent, you won’t have to bring him in so much for stuff like this.” I had brought him in exactly ONCE before for a raging ear infection. I had NEVER brought him in for little things–she just hadn’t read his chart, and assumed that because I brought him in for something small this time, I was some kind of parental hypochondriac. I am still pissed about her condescencion and her failure to even read our file.

One time I asked a question based on something I read (the connection between not crawling and dyslexia) and the doctor (again, not my usual doc) said “Where’d you read THAT? Cosmo?” I think she meant it as a lighthearted joke but I thought it was pretty inappropriate. The right response would have been “I don’t think you should be concerned, but tell me more about this; I haven’t heard of that.”

2

I honestly can’t think of anything I really dislike about our pediatrician or her partners in the practice. The only minor complaint I have is that office visits tend to be brief, but I think she gives us the time we need.

I think the best thing has been that she is really observant. She checks all the basics at each visit, but has caught some unusual problems early as well.

To give just one example, when my son went in for his first checkup after he was born, she notices that he was favoring one side when he looked around. She made a diagnosis of torticollis and recommended physical therapy. Within a few months he was fine. In contrast, another baby who was going to the same physical therapist hadn’t been diagnosed until she was 15 months old and the therapist told us she might never fully recover.

The other thing we really love is our doctors’ availability. We can call the answering service any time and whichever doctor in the practice is on call always gets right back to us. It’s wonderful not to have to drive out to the emergency room to check on everything.

3

I really like my pediatrician. Some of these things may be more for a Doc that is in a private practice but I am going to list them all. If he does move into private practice they would be good to keep in mind.
The Good:

  1. She never made me feel bad about bottle feeding my son.
  2. I changed to a soy formula without asking her first. I was nervous about telling her but did anyway. She asked why without being accusatory. I gave her my reasons (he was curling into the fetal position and screaming with gas about 20-30 mins. after eating ) and she said that it sounded like I knew what I was doing, which is about the best thing a new parent can hear from a pediatrician. Moral to the story: encouragement and confidence in the parent’s abilities.
  3. Having never been around baby boys before, I was shy about cleaning and putting Balmex on and around my son’s genital area (it felt kinda wrong at first). This led to a horrible diaper rash in between where his legs meet his groin area. Well, I had no idea what diaper rash looked like either so I didn’t know what it was. She calmly looked at it and didn’t make me feel like an idiot. The thirty seconds she spent checking out what she knew was going to be diaper rash probably saved her a 15 minute phone call later. (As a funny aside [well, now it’s funny - it wasn’t at the time] I spent a week waiting on Child Services to come take him away due to my horrible neglect that led to the diaper rash. I watch too much ER.)
  4. While I was still in the hospital she sent me a booklet that had their office numbers, what to do in an emergency, what the difference was between and emergency and what was not, what to do for common ailments and a section outlining their policy on walk-in visits, an immunization schedule and stuff like that.
  5. She always compliments my son and talks to him, even though he’s only 8 wks. old.
  6. They do everything required for the check-up and save the shots for the very last thing so I can take him home immediately afterwards and calm him down.
  7. After she is done she puts her chart down and gives me her full attention and says “What questions do you have?”

The Bad:

  1. After the Hep B vaccination my son screamed so much you would have thought the nurse had pulled his legs off. The office staff was looking at us like “How long is that baby gonna cry?” You should expect babies to cry after a painful shot.
  2. I would like to have the option of speaking to the dr. on call instead of waking up my doc if I call in the night. I am very hesitant to call at 3 am if she is going to be gotten out of bed.

The Ugly:
Her associate charged me $60 for a five minute visit in the hospital before we were released after he was born. :frowning:

I will have more after I think about it. I will let someone else get a word in first, though

BTW, it looks alot like I am following you around the board. If you get any letters saying “I know what you did last summer” don’t look at me! :slight_smile:

4

I only have one thing to add:
The doctor should actually talk to his patients during the exam. I have seen too many (OK, only 2) who would address the parent and treat the kid as an object rather than a person. The kid is already nervous about seeing a doctor, it doesn’t help to be ignored too. The last pediatrician I found actually talked to my son, explained to him what was going on, and fielded any questions he might have had.

5

I haven’t used a regular pediatrician since my daughter was 6 months old. We all go to our regular family physician now. I like the fact that our doctor talks to the kids while he’s examining them and has a very soothing voice. It makes them less nervous and me less nervous! He also asks us if we have any questions or concerns about their medicines or diagnosis.

What I don’t like:

When giving a baby it’s shots do all of them as quickly as you can. I had one lady give my son one shot, clean the area, put on a band-aid, then give him another shot and so on. He would just start to calm down and she’d stick him again. Do all 3 (or 4) of them one right after the other and then put the band aids on!

6

It would be good if pediatricians who did not have children or were not the primary care-givers of their own would acknowledge a parent’s knowing their child best. Small changes can mean a lot and a parent is with their child 24/7.

7

We had an interesting problem with our pediatrician. He seemed to like the Kunilou kids a lot less as they got older. After each of them hit the age of 11 or 12 the examinations got more perfunctory and our daughter’s nagging illnesses were basically shrugged off. When my daughter hit 17, we moved her to the family doctor, and the boys, who are younger, are now seen by another doctor in the practice.

8

Take parents seriously. I really am expert on my kids and what issues they face. I really do know more about it than any paed I’ve met so far. These kids are my life - a paed is gonna meet a kid like mine maybe once in 20 years. There’s no way they are up on the research in the way that I am.

If a paed doesn’t understand why I won’t do what they suggest then ask me. I’m usually happy to explain my logic. And never assume a parent of kids with special needs is ignorant. I’m still irked with the idiot who recently told me that my younger kid appears to be autistic because of the measles vaccination… Because I am aware of the research about the link between autism and measles (not convinced but aware ) my kid is not vacc’ed. But hey way to go making the assumption that I was ignorant…

Be open to the fact that there can be more than one issue which needs solving. I’m sick of one size fits all solutions.

9

The first pediatrician we had was an incompetent shithead. I apologize for the profanity, but she was. When we took our eldest son to her for checkups, we saw only the nurse (who was competent) but were charged for doctor’s visits. When my son had his first asthma attack, we were terrified. I wasn’t a nurse yet, it would be years before I went to nursing school, but any moron could tell my boy was in serious trouble. The doctor (who had never seen my son, though we’d paid for several doctor visits) told us she’d meet us at the hospital where she was on call and just charge us for a regular doctor’s visit.

So of course, we wound up paying $400 for the emergency room visit, plus the doctor’s fee, plus a couple hundred more dollars for one breathing treatment. Now, we know our son has asthma. My best friend told me she also used that pediatrician at first and her daughter had such a severe asthma attack that she almost died, but this doc didn’t diagnose asthma. After Susan and I were both in nursing school, we couldn’t believe what a dangerous moron this doctor was: we saw many children who clearly had asthma, but this doctor would give at max one breathing treatment before sending them home.

Our present pediatrician is an angel. He took one look at Jake (my second oldest) and said, “He has arthrogryposis, doesn’t he?” Until that moment, I’d never met a doctor in our city who had ever even heard of this birth defect, much less been taught how to recognize it. It’s a rare defect that occurs in approximately one in 5,000 births. I fell in love with Dr. Fletcher instantly.

Dr. Rex Fletcher treats our children like people (which they are). He doesn’t frighten them. He talks to them on their level, and they love to see him. He remembers that I’m a nurse and doesn’t talk down to me; I suspect that he tailors everything he says to the individual to whom he is talking. Psychosocial skills, in my opinion, are absolutely critical in pediatrics.

When my oldest is hospitalized with asthma, Dr. Fletcher sends him home with me: he knows I’m capable of giving the IV antibiotics and breathing treatments correctly and on time. He encourages me, he treats my children well, and he shows genuine concern for my kids’ welfare. What more could a mom want?

10

The good: We lucked out with our pediatrician. He always seems to give us however much time we need, and we never seem rushed. Now that my girls are older (9, almost 8, and 5 1/2) he talks to them about what they’re doing in school, what they’re doing during the summer, etc. He really seems to interest himself in what they’re doing, not just in their health. This seems to make for more relaxed children in what could be potentially stressful situations.

Also, his office staff is great. And they validate parking. :slight_smile:

The bad: Because he takes his time with his patients, the waiting room can get pretty backed up, and waiting 45 minutes is not unheard of.

The ugly: Filling out forms for school/camp is now $10 a form.

11

The good:

  • He rarely makes us wait, ten minutes max. When our doodles was still in-utero, OB/GYN visits regularly were proceeded by hour-long waits.
  • We get in when we want. If we call and feel that doodles needs to be seen today, the answer is “what time today is good for you?”, not “we have an opeming in two weeks.”
  • We never feel rushed, and all are questions are answered.
  • The doc takes time to make doodles comfortable. One weekend we had to see the on-call doc who wanted to check her ears and just went after her without any gentle playing or instrument introduction. That sucked.
  • He’s honest. If he doesn’t know what’s wrong, he tells us.
  • He listens to us and makes us become part of the process. Sometimes there are no easy answers, so he will give us options in treatment.
  • He made us interview him. It sounds odd, but before he took us on, he had us come down several weeks before birth and explained himself, his practice, and his philosophy. He has some very definite opinions, (especially about pregnant women smoking), and if we weren’t comfortable, then he told us that he wasn’t the right doctor for us.
  • He’s a whack-job, in a good way. Wears jeans, t-shirts, and bedroom slippers in the office. Always helps to have a little insanity floating around.

The bad:

  • Tends to use high-falutin’ med-school terms for everything. Very professional and accurate, but sometimes we need the info dumbed down. Which he will do if asked.