7 Ways to Have a Good Doctor's Visit
When discussing your child's health with the pediatrician, it's not your job to be a health expert. That's what the doctor is for. But it's smart to try to play an active supporting role. After all, in this era of rushed appointments and referrals to specialists, we're often the ones coordinating our kids' medical care and following through to ensure they get the treatment they need.
"Having health literacy—accessing, reading, understanding, and using information in order to care for your loved ones—is an important parenting skill," says Mary Ann Abrams, M.D., M.P.H., clinical assistant professor of pediatrics at The Ohio State University College of Medicine and Nationwide Children's Hospital, in Columbus. It's also a universal challenge: In a national study that involved more than 6,100 parents, researchers from the New York University School of Medicine found that 29 percent of them had difficulty obtaining, processing, and understanding basic health information they needed to make good health decisions and 59 percent had trouble understanding labels on over-the-counter medication, which increased their risk of making mistakes when dispensing common medicines to their children.
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Children whose parents have low health-literacy skills may have more hospitalizations and emergency-room visits, more flare-ups of chronic conditions like asthma or diabetes, fewer vaccinations, poorer control of their symptoms (whether it's pain, congestion, or something else), as well as more adverse reactions to medications. Doctors and health advocates say that they see this on a regular basis, with parents of all backgrounds, and sometimes with unfortunate results.
The good news is that becoming a well-informed advocate for your child isn't as hard as you might think. Stick with these strategies during the next visit, and work more effectively with your child's doctor.
1. Share key details.
To avoid omitting any essentials, especially when you're worried about your child and/or you're sleep-deprived, jot down info before the appointment and bring it with you. Yes, this is basic advice, but parents don't always take the time to organize their thoughts ahead of time, says Alanna Levine, M.D., a pediatrician in Orangeburg, New York, and a spokesperson for the American Academy of Pediatrics (AAP). "When you're in the moment, it's easy to forget all the points you want to get across." Be sure to tell the doctor when your child's symptoms started; how they affect him physically, emotionally, and behaviorally; whether the symptoms are constant or intermittent; what makes them better or worse; and other crucial points.
After her twin boys were born with various health problems—one had a heart defect, the other had a gastrointestinal blockage, both of which required surgery—Natalie Bushaw, who lives in Inver Grove Heights, Minnesota, quickly learned how to keep track of their symptoms, medical procedures, and treatments. She created a cheat sheet on her phone with their medical history and details from every medical appointment. "Referring to it is way faster than having a doctor go back through the charts," she explains.
2. Make sure you understand your doctor's language.
"Doctors often have to repeat a lot of the same information and sometimes we forget we're speaking doctor-ese," says Davis Liu, M.D., a family physician with the Permanente Medical Group in Sacramento and the author of The Thrifty Patient: Vital Insider Tips for Saving Money and Staying Healthy. If you don't understand a term she uses, ask for clarification; it can mean the difference between comprehending what your child has and how to treat it—or not. (Check out "Translation, Please!" below.) And it's always helpful to ask, "When is my child going to feel better? What can I expect to happen over the next week? How will I know if things aren't improving? What do I need to watch out for?" recommends Dr. Liu.
Before you leave the appointment, repeat the highlights back to the doctor to make sure you understand them correctly. Dr. Liu suggests this mnemonic device for every appointment: DATED. D is for Diagnosis (What does my child have?); A is for Additional testing (Is it needed, and why?); T is for Treatment (What does it entail?); E is for future Evaluation (Should my child have a follow-up exam? What symptoms or complications should I contact you about?); and D is for Due (as in, what other routine immunizations or blood work is my child due for?). If time runs out and you still have questions, ask for a follow-up appointment, an after-hours phone call, or an e-mail consultation.
3. Keep a record of the appointment.
When you're feeling anxious, it can be hard to remember what the doctor is telling you. But if you write down what he says or even record the conversation with your phone—it's legal to do so with your doctor's permission—you'll have detailed info to refer to later. If your child is particularly sick or you're feeling stressed, consider bringing a trusted friend or relative with you to take notes or ask questions you may not think of. This helps take the burden off your memory, especially when you're experiencing information overload. Many doctors are open to this, especially if a child has a chronic condition or a complex medical issue, because it makes it easier to take that info to a specialist if need be, says Tanya Altmann, M.D., clinical assistant professor of pediatrics at UCLA and author of Mommy Calls.
4. Ask for reputable resources.
To help you read up on the basics of your child's condition (which can make it easier to formulate the right follow-up questions) or to help you decide when a symptom is serious enough to warrant a doctor's visit, ask your doctor to steer you toward reliable websites and books.
5. Check your medication-dispensing techniques.
Make sure you understand exactly how to administer a particular drug to your child and what the correct dose is. This is key with asthma medications, Dr. Abrams says; parents and children don't always use inhalers correctly. Even with over-the-counter drugs, determine how much to give your child based on his weight rather than his age.
If you're picking up an Rx at the pharmacy, remember that the pharmacist is a great resource. She can help you understand what an "empty stomach" really means or advise you on the best dosing device, since using the wrong dispensing tool can lead to a dosing error. Pharmacists can also tell you, for instance, whether a certain drug could lessen the effects of other medications or make your child more sensitive to the sun.
6. Feel free to seek second (or third) opinions.
But first, talk to your doctor. If you're not sure you agree with his assessment or recommendations, let him know. He may be able to try other things or adjust what you're already doing. If you're still unsure, don't feel guilty about seeing another professional for her opinion.
Carly Fauth looked for a second opinion when her son Ryker was frequently sick between the ages of 1 and 3. His pediatrician couldn't figure out why he kept getting ear infections, coughs, upper-respiratory illnesses, swollen tonsils, and high fevers on a near-monthly basis. After doing research, Fauth became convinced that his tonsils and adenoids should be removed. "His pediatrician wasn't overly fond of that idea," recalls Fauth, of Milford, Massachusetts, so she took her son to an ear, nose, and throat specialist, who agreed that the surgery could help. She brought this up with her pediatrician, who reconsidered his position. Ryker went on to have the surgery; he's now 6 and greatly improved, says Fauth.
7. Involve your child in the appointment.
To raise health-savvy children, let them participate in their doctors' appointments as they get older. By age 6, most kids can start answering questions at a checkup or describing their symptoms at a sick visit, says Dr. Abrams. By adolescence, they can help fill out their own health forms. "Parents often think it's just easier to do it all themselves," she says, "but you want your kids to be able to take care of their health and eventually take more responsibility for their own care." Think of it as a way of passing the torch: You'll be helping your child understand how to become a strong advocate for his or her own health—a gift that's valuable for life.
Translation, Please!
Most doctors try not to, but sometimes they engage in medical-speak that can leave you wondering what the heck they're talking about. If you don't understand something your doctor says, speak up. In the meantime, this jargon decoder may help you decipher some of what you're hearing.
Acute: a symptom or condition that occurs suddenly or has a short duration
Effusion: fluid in a body cavity (like the middle ear)
Fracture: broken bone
Idiopathic: no identifiable cause for a condition
Nebulizer: a medication-delivery device that allows a drug to be inhaled in mist form (for croup, asthma, or other respiratory diseases) through a mask or tube
Negative test results: They're normal. Ironically, you generally don't want a "positive" result.
Paradoxical effect: an effect that's the opposite of what you'd expect (if a sedating antihistamine makes a child hyper or excitable, for instance)
Unremarkable: normal. Phew!
