Five things I say in Clinic (in no particular order). After reading this, you’ll be all set for Family Feud when the category is Things Pediatricians Say.
Number One: I’m so sorry you’ve been waiting for me.
The reason is often varied. I’ve not been picking my nose or even doing something as productive as blogging. Usually I’m running behind because a patient or two arrived tardy for check-in or I’ve had to return a call to a doctor at the hospital or a family needed more time for an urgent health concern or a patient scheduled an appointment to talk about one thing (say a medication refill) and then wants to talk about three things like starting birth control or their struggle with obesity or a new challenge at school or a rash or because I needed to “double book” a sick infant who needs urgent care. The reasons are unpredictable, clearly, and I hate to make anyone wait, but I also hate to have families leave without comprehensive care. I work my tail off (as do my magical medical assistants) to stay on time, yet inevitably I am set up to fail. It’s an unusual doctor who never runs even a minute behind in a general pediatric practice. I sincerely hate to have people wait for me, as it’s a huge added stress for us all. Starting all visits with an apology makes for a terrible day. So next time you find yourself stuck in some waiting room with your toddler (+/- your 3 other children) and you’re going bananas, know that when your child needs the extra time or attention, they’ll get it, too. And if they never do—lucky you.
Number Two: If it were my child, I would get the flu shot.
Both of my boys got their nasal flu “shots” last month. And both have had them yearly since they were born. The single best way to protect against Influenza infection is to get a flu shot. Even though current influenza activity is low, it’s a great time to get a flu shot as flu tends to peak later in the winter. Often protecting kids over age 2 doesn’t even involve a poke (ask for nasal spray)! Outlook looks great for this year’s flu shot. Unfortunately, in the 2010-2011 season, over 122 children passed away from Influenza, a vaccine-preventable disease. Wild myth exists about the flu shot. Read this if you have concerns about safety or ineffectiveness of the flu shot. In addition to washing your hands, staying home when sick, covering your cough, and avoiding sick people (!), the flu shot remains an incredibly effective way to protect your family.
Number three: You must be so tired.
Parents to newborns are exhausted. Doesn’t really matter if it’s baby #1 or baby #3. It’s simply exhausting to birth a human, let alone support a newborn. Feeding a newborn is a full time job in and of itself. In clinic, I ask parents if they are exhausted. And then we talk about the typical crying and fussiness in infants. Did you know babies cry more around 6 to 8 weeks of life than ever again?
Number Four: Your child is beautiful and healthy!
The five most common reasons children are seen in clinic are due to lung infections, asthma, trauma/injuries, ear infections and mental health complaints. Forty percent of children are seen yearly for one of those complaints. However, the most universal reason a for visit to the pediatrician is for a “well child exam.” Now it doesn’t mean that every child is without health complications, but at wellness visits we focus on growth, development, nutrition, safety, and prevention. Lucky thing, children are resilient. Because of this, I have the utter luxury to proclaim and pronounce health many times a day. “Beautiful and healthy” baby, child, or teen.
Number Five: Are you making good choices?
I ask nearly every adolescent this question at some point during a check-up. And I didn’t learn it in med school; I learned it from my brother-in-law. But the answer is telling. Teens certainly know if they are working to protect themselves or not. But it doesn’t mean they understand risk. Teen drinking & cigarette smoking continues to decline in the US (hip hip horrah!) but marijuana use is up. One in every 4 teens use marijuana. And many teens tell me about their friends drinking and driving. Or their belief that drug use doesn’t impair judgment. On top of drug use, we know that teens are struggling with their use of digital devices and their consumption of technology, their lack of sleep, and ongoing challenges with mental health, especially in this down economy. On the flip side, we also know many teens are thriving, volunteering, actively participating in sports teams, forming exceptional friendships, and excelling at school. The reality is this: you can learn a lot with one question. Maybe ask it, too?
Emily Gibson says
I do really like question #5 as an entry point into teenagers’ lifestyles. I’m not sure how often they will voluntarily tell their physician about their riskier choices without some specific follow up question–in my college health practice, we take a marijuana and alcohol history at the same time as the tobacco history–just as the nurse is doing vital signs, she’ll ask the “how recently have you used…?” question.
The rate of THC use is astounding, as is the increasing numbers of adolescents with medical marijuana cards for issues like migraines, insomnia and (?!?!) anxiety.
molly says
you are a favorite with our family. you truly care about your patients and it really shows. thanks for doing what you love and loving what you do. merry christmas from the barrans!
Holly (MD) says
Your #1 is my #1 as well. Although, over the years, I feel better about my day when, instead of apologizing for being behind, I instead thank the waiting family for their patience. Spinning/semantics/whatever. It makes for a more pleasant start to the appointment!
Dr_som says
I love this: “know that when your child needs the extra time or attention, they’ll get it, too. And if they never do—lucky you”
However, I do think examining rooms are not kid friendly. I always wished they looked more like an OT or PT room.
Ora says
If I were ever a child again, I would want you for my pediatrician. Instead, I’ll happily remain your nurse colleague in keeping kids healthy, caring for them when/if they get sick, and helping parents and grandparents do it all…and better, because they understand more.
Marjorie Shanks says
All five great things to say in clinic and in life! Thanks for sharing.
Sue Woods says
These are great. I ask ask, Do you have Internet access? Do you go online for health information? (We use secure email now….)
Nurse Jennie says
This is all such great information . . . I have not gotten my kids flu shots but will now go and schedule them 🙂
Vera says
Such great advice, even for non-pediatricians – I have to remember to apologize to my kids (or others) when something else (whatever the reason) keeps me from giving them my attention, and I do ask my children if they are making good choices. Even at 4 and 6, I’m always surprised at how aware they are of their good and bad choices! (And yes, I am tired. Ha!)
Chris says
This is kind of on topic, and somewhat an “FYI.”
Earlier this month my son spent two days at the UW Medical Center hospital. While getting coffee at the gift shop I noticed they were selling a magazine called “Autism File.” Among those on the list of editorial staff was Andrew Wakefield, who has a dubious reputation in the area of vaccines and autism.
I complained to UWMC, and during one of my son’s many follow up appointments I noticed there were no more copies in the gift shop.
Last week I went to Children’s to see if it was in their gift shop, but now there is much more security (very different from when my son was treated there). Since I had just given blood I did not want to go through the hoops. I am just hoping that there were no copies in their gift shop (by the way there were some in the QFC down the street, but being next to where they sell homeopathy one cannot say it goes against store policy). I just thought I would make you aware of this. Thank you.