Wednesday, June 13, 2012

5 Things Moms Want In a Doctor

Most doctors and pediatricians get into the profession because they want to help people. Most pre-med students and doctors I've talked to always say that they got interested in medicine because they want to make people feel better, they had a positive medical experience or a negative one (either themselves or through a relative) and they want either emulate that experience or make it better for others, or they love science and want to make life better for others. I've never heard anyone say that they want to go into medicine because they want to intimidate people, de-humanize people, ignore people, or condemn people for decisions that they've researched more thoroughly than they have. And yet, I've known many moms who have mentioned these three exact reasons for why they are switching doctors either for themselves or their children. I've even read about moms who purposefully lie or refuse to discuss things with their doctors for fear of being disrespected, disregarded, and disparaged. I'm sure that there are no doctors out there who would say that what they want patients to do is lie to them. So, where's the disconnect coming from?

I think that most doctors, even the ones who the moms are complaining about, probably do want to help people, they just aren't aware of what they are doing that isn't helping. So, I talked to some moms through the connected mom facebook page and some of the moms I know in real life, and I decided to compile a list to let doctors and pediatricians know what it is that parents really want in a doctor. These are the keys to getting parents to stay with your practice and developing honest, long term, and open communication with your patients.

1. Be honest yourself.
Be honest not just about what you know, but also about the scope of your knowlege and what you don't know. Don't be afraid to say when you don't know something or you haven't done much research about something. This sounds like one that would be easy, but when you are in a position of authority, you might have the urge to pretend you know more than you do. Don't. That was one of the biggest red flags moms complained about with doctors. Parents care about your credentials and that you are knowledgeable, but they care more about your honesty. My son had to go in for cranial surgery when he was ten months old because of a dermoid cyst located between his growth plates in his skull. The first two doctors I saw in our family practice were very honest with me that they thought it was probably a harmless cyst, but they honestly didn't know what kind of cyst could be so rigid and if that cyst was dangerous. They then gave me the option of pursuing more tests and seeing specialists. Their honesty helped me to get an accurate diagnosis for my son and he ended up with a surgery. It turns out that had the doctors bluffed me into false security, my son likely would have ended up with brain damage because we were (literally) micrometers away from neural damage. I did not choose new family doctors and I did not lose confidence in them because of their honesty. Instead, their lack of knowledge became an integral part of my decision making and likely saved my son from permanent consequences.

2. Treat every patient (no matter how small) as important
One of the most beautiful responses to my question of "What do you look for in a pediatrican or a doctor?" came from a mom on the facebook page. She wrote: "At my son's first pediatrician appointment, she took him in her arms,looked directly in his eyes and said "Welcome to the world, I am so very glad to meet you!" Another mom wrote, "I also look for a pediatrician (or family doctor) that actually talks to us, especially our daughter, rather than asking question after question. You get a lot more by talking to a child about their lives than asking pointed questions at their parents." Moms were clear that they didn't care how long they had to wait for an appointment as long as they felt they and their child were well cared for during their own appointments. Little differences, like making eye contact, asking before you touch them or their child, talking about the child's health rather than just running down the checklist of questions, made all the difference in whether or a parent would continue taking their child to you. As yet another mom put it, "If a doctor acts like they're too busy for me, it's always my last appointment with them."

3. Be respectful.
Parents look to you to provide accurate, educated health information and recommendations to parents so that they can make good decisions for themselves and their children. Because they are in the position to make the ultimate decisions, remember to respect their questions and their opinions, even if they are different from your own. One mom wrote about her annoyance with her doctor's fixation on her child's place on the low end of the growth chart. She and her husband are both small themselves and were also small as children. While it is her doctor's job to point out that her child falls outside the norm on the growth chart, the mom knows that her child eats well and is healthy. She gets frustrated that the doctor seems to "judge" her for not wanting to take action.

Likewise, there may be times when you disagree with a parent's choice such as when a parent chooses not to vaccinate, but you must respect that even though they have made a choice that you may not approve of even after you have given them all the information you feel is important. The decision is ultimately their's and not yours. Most moms seem to be fine with you giving an opinion contrary to their own as long as you show them respect for theirs. As another mom put it, "The most important thing for me is getting a sense of mutual respect. I don't feel like I need a pediatrician who agrees with all my parenting choices, but I do need someone who respects them and whose opinion I can respect. I want someone who will work with me and who is alright with me being informed and engaged, not someone who will do whatever because he says so."

4.Don't overstep your bounds.
Be clear between your research and your opinion. If a parent asks your opinion, of course you should give it, but make a clear delineation between what you know from personal experience and research and what you just think. Offer it as a piece of advice not "doctor's orders." For example, if a tired parent comes in and asks about sleep pattern normalcy, tell them what you have researched as in the normal range for that age because that is the medical, physical answer, but don't offer opinions on what that parent should or shouldn't be doing. You are offering medical information, but parenting decisions are up to each parent. You may never choose to bedshare, breastfeed, or cloth diaper, and you may believe that tantrums should be ignored or that infants shouldn't be held too often, but these are all highly personal parenting decisions that should be made by the person with the most experience with each individual child. While you may have seen that child every month for about twenty minutes to an hour since he or she was born, that parent has been with them all that time plus the other 23 hours a day. As one mom put it, "I really don't like it when doctors give you parenting advice, such as what to do about a temper tantrum, how to get your child to not throw things on the floor, sleep training, etc. I feel they are not trained in it and don't have any authority in that area[.]"

5. Don't forget how important everything you do can be.
What may be a routine diagnosis or procedure for you, may be intensely scary or life changing for a parent or a child. Make sure to show your compassion for people alongside your passion for medicine. Make sure that you soothe nerves and worries as well as you heal wounds. I remember that the second my son went limp from the anesthesia for his operation, my child was taken from me and I was told to "quickly give him a kiss and walk away." When it took me more than three seconds to respond and disappear, I was given the order more sternly. I understand that they were in a hurry to intubate him and that they were focused on my son's surgical needs and the task at hand, but they clearly didn't realize that my whole life was on that table and that I needed a few seconds to process that. I needed someone to actually look me in the eye and say, "We'll take care of your baby."

Thanks for reading and I hope this has reached a well meaning doctor somewhere!



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