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Karen Wang
BY Karen Wang

10 Ways to Improve Communication with your Pediatrician

Pediatricians often find themselves in the position of treating an anxious, confused patient while simultaneously trying to develop a professional relationship with an anxious, confused parent.  When special needs are added to the mix, those relationships become even more complicated.

Pediatricians are highly trained in identifying and treating illnesses in children. In my experience, some pediatricians may be less well-trained in identifying and recommending treatment for issues related to development, sensory integration, sleep and feeding. In these cases, both parties may be trying to educate each other, and communication on both sides may become fraught with condescension, suggestions of incompetence and even suspicion of wrongdoing.

My family has had to switch pediatricians a few times over the years due to insurance changes and moving, and I learned that quality of care varies widely even in the same geographic area near a major research hospital. I also learned that certain steps on my end can significantly improve the care that my child receives while also improving communication between my family and the physician’s team. If your child is like mine and has frequent, long appointments with lots of questions, consider these methods to get the most out of your office visit.

1. Bring a spouse or older relative

Pediatricians may dismiss a parent’s concern if the child is gaining weight and appears otherwise healthy. This happened to me! It is important for a physician to know that several adults actively involved in a child’s life all share the same concerns. I learned that bringing Grandma along makes a big impression on the office staff.

2. Bring notes and toys

If a child is going to be evaluated for special needs, the parent has to be prepared to explain the child’s history. This means bringing detailed notes, observations and questions. How large is the child’s vocabulary? What exactly does the child eat and how much? How much tummy time? How much outdoor time?

In addition, the child needs to be prepared for the time spent in the interview. That means packing familiar toys, maybe a doctor’s kit and doll to be the “patient,” and stories to read while waiting, including social stories. Part of a pediatric check-up involves observation of play skills, so the toys help the pediatrician gain a better understanding of the child’s abilities, too.

3. Attitude

Taking a child with special needs to the doctor can be a harrowing and emotional experience for both parent and child. But the best way to support the child is to model coping skills and confidence in pursuing better health.

A pediatrician once told me that my son’s demeanor reflected my own demeanor: if I was anxious, my child would be anxious, too.  He said this while my son was in the middle of a full-blown panic attack after waiting 45 minutes in the exam room.  Although I was able to remain mostly calm, it’s true that I did not have a very positive attitude at that moment.  We got through it with hugs, singing and walks around the office building.

4. Early intervention

Parents do not need a pediatrician’s permission to pursue early intervention in the USA. Early intervention is recommended for all babies, toddlers and children with a suspected developmental delay. Yet some pediatricians still advise parents to “wait and see” if a child catches up on milestones, even with documented delays and a family history of disability.

One time I was disappointed that the pediatrician on call told me to bring my son back in 6 months, “because a spontaneous developmental breakthrough is still possible at his age,” so I went straight home and scheduled the first available appointment with the school district’s early intervention team.

5. Is waiting a problem?

Long wait times in the reception area and in the exam room are a big problem in many medical offices, and an even bigger problem for children with special needs. Be upfront if waiting is going to be a disaster. Reschedule if necessary, or ask the nurse to send a text when the wait time is down to 5 minutes.

6. One long appointment or several short visits?

Usually I plan to spend half a day, but sometimes several short visits are preferred to acclimate a child to the doctor’s office. Right after we moved, I took my son to a family physician who informed me that questions about developmental delays or neurological issues are not permitted during well-child visits, and I would have to schedule a separate appointment for each concern. While scheduling the appointment, ask what the expectations for the appointment will be so that there will be no surprises like this.

7. Prescriptions

Did you know that physicians can write a prescription for a child to ride an air-conditioned school bus? Or for extra time to move between classes? Or for hippotherapy? Prescriptions for speech, occupational or physical therapy can increase the chance of having it covered by insurance, too. If a pediatrician gives instructions that may be difficult to remember, ask for it to be written out. Prescriptions are not just for meds!

8. Community resources

For parents who are just starting to learn about their children’s special needs, a pediatrician can provide information about community groups, therapy clinics and parent training opportunities. Add that to your list of questions!

9. Referrals to specialists

Most pediatricians do not have detailed, specialized knowledge about all types of disabilities. If answers are not forthcoming, request a referral to a specialist such as a developmental pediatrician, neurologist or gastroenterologist.

10. Second opinion

Sometimes parents disagree with a pediatrician’s recommendation. If a second opinion is needed, go to a physician who works through a different hospital. Many hospitals require physicians to follow specific procedures in diagnosing and recommending treatment, so the recommendations are likely to be the same within the same hospital network.

Make sure the pediatrician knows that a second opinion is being sought. When parents refuse medications, invasive procedures or other treatments on behalf of their children, they may be labeled as difficult for going against medical advice (AMA), or their children may even be denied care in the future. Mistrust grows rapidly on both sides when a child’s well-being is at stake. That’s why positive communication skills are an essential part of pediatric care.

Have a doctor experience you would like to share? Tell us about it in the comments section below.

Karen Wang

Written on December 17, 2014 by:

Karen Wang is a Friendship Circle parent. You may have seen her sneaking into the volunteer lounge for ice cream or being pushed into the cheese pit by laughing children. She is a contributing author to the anthology "My Baby Rides the Short Bus: The Unabashedly Human Experience of Raising Kids With Disabilities"
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