Advice about Visiting the Pediatrician

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Feeling pissed off at pediatrician/group practice

July 2014

Today's appointment for my 2-year old has left me so rattled. I'm wondering, ''is it just me?'' I know I'm going to leave this practice, because the issues are chronic and kind of unsolvable. But I wonder how I can improve the experience for myself and for my anxious little guy, at the next place? I'm looking for compassion or insight or like experiences, please.

What's your experience and how do you handle these types of pediatric-office problems: chronic tardiness by the doc or NP? Canned or script-type answers coupled with blank expressions and lots of empty ''uh huh, uh huhs'' after you speak? The doc going off on tangents unrelated to the nature of the day's appointment? Circular answers to your simple questions? Condescension? And how to have a dialogue with the doc while your child is squirming &/or screaming.

I've been to a total of two group practices since my son was born, and both have had similar issues. I start to wonder if there's something wrong with me, with group practices, or both, and I beat myself up for it. (i.e. ''Can't I get along with anyone?!?'') But of course I can, and do. And besides, I know a gal who switched UNIVERSITIES three times, and she's a wonderful, smart, kind person. It was for the best, in other words. Sometimes we have to switch something up a few or more times 'til it fits, I try to tell myself.

Let me give you a real example from today:
NP asked how many words my son has said now?
Me: 80. NP: Then why is he in speech therapy?
Me: Well, it was only like 15-25 words at the time he turned 2. And here we are.
NP: What was the speech therapist's evaluation?
Me: In a nutshell: he's got mild speech delay/is a late talker, versus having a *language* delay.
NP: Hmmm....OK. Well, does he say 2 or 3 word sentences?....

And on it went. If I say he's in ST and it's going well, and he's making progress and loves preschool, what is there left to question? I felt like she was trying to root out *something*, and it made me really uncomfortable. Is this a God-complex?
Scripted protocol? A personality clash?

Keep in mind, this was for a simple recheck of his ears, to ensure he had no leftover fluid in them from a couple recent ear infections (and no, there was no more fluid). End of story. Also keep in mind my son was being grouchy and loud, all the while the NP asked me question after question. I started to feel grilled and accused of something. Questions are good, yes! But what about context? I pushed back and questioned her questions a bit. I felt like she was looking for a problem where there wasn't any. And when I pressed her, ''do you have some concern behind all of these questions? We're just here to check his ears?'' She assessed ME, and noted how I ''twitch'' every time my son would squawk or fuss in this appointment. I was pissed of course and said, ''are you judging me?!?'' That's about as heated as it got.

So is this just me? I'm a friendly person and I give everyone a chance; I'm also sensitive and get pissed off rather easily. Nobody can speak for this clinician, I know, but I'm still looking for ''answers'' from my peers. Thanks... Parent

It sounds like you aren't going to be happy in any practice.

Of course the nurse was asking specific questions about speech. It's directly tied to ear infections, chronic or not. I would be pleased that the practice sounds thorough actually. Not one of the questions you mentioned was inappropriate or unexpected.

As far as tardiness of NPs and physicians, every patient deserves time and attention. Kids can be a challenge to treat and examine, and parents can ask a million questions. If one patient is late, it can throw the entire day off and you never get caught up. Likewise, if there is an emergency, something else that is unexpected, or something that just needs to addressed, it is going to push everything back.

Instead of looking for another practice, I'd look to your own expectations and figure out how you are going to manage them. momto4

Your question sounds like an advice request since you state you are seeking ways to improve your experience at your next pediatrician, insight, compassion, and how to handle particular pediatric-office problems (tardiness, style and content of communications, perceived condescension and how to have these conversations with a squirmy or crying 2-year old). But I'll take a shot at it here.

First, with your next pediatrician's office, see if they are willing to meet with you briefly (10 minutes?) over the phone or in person before you move to the practice, so you can ask more about the philosophy, communication style and logistics. if you hate tardiness, ask (politely) when you are making an appointment what time will give you the best chance of your appointment starting on time. It might be first thing in the morning or first one after lunch. If several patients at the beginning of the day are late for their appointments, it can delay all the subsequent appointments as well, so early may be better for you.

Another thought is ... If your child had an ear infection, and the doctor or nurse asked about reasons for speech therapy, they could be trying to learn more about your child's history and current status due to the fact that repeat ear infections can affect hearing, and hearing affects speech development. In which case they may refer you to an audiologist for a hearing test. If that is the case, they are to be commended for being thorough.

Sounds like a matter of different communication styles, in which case you might seek a practice that is more in line with your style of communicating. Since no one is perfect, you may be trading one set of strengths and weaknesses for a different set.

You should find a practice where you are confident in the doctor's expertise. Once you do that, you have to trust that they are asking certain questions for a reason. While it may not be apparent to you, there could very well be a reason.

I would suggest asking about their line of thought in a less aggressive way, as a two way dialogue is important. Also, your example of the speech therapy didn't seem unreasonable - she wanted an update on the progress from your perspective. As the parent, you would have a lot of insight into whether things seem to be working or not.

As far as how to have a conversation with a squirming, you just do. Welcome to parenthood. I am not exactly sure what the alternative would be.