Introduction
As a parent, you know your child or teen better than anyone. You know how to make him laugh and how to soothe him. You know what her best qualities are and what she needs. When you go to the doctor, you play a key role in helping your child’s doctor* know and understand your child’s strengths and needs, and what services would be helpful.
A “Medical Home” partnership between doctors and parents does not happen automatically. In fact, many times the most successful partnerships are because the parents –you — make it happen.
There are many steps you can take to create the type of partnership and relationship that you want with your child’s doctor. This page gives suggestions and ideas for getting started with a new doctor and also for improving a relationship that you already have.
* For ease, the word “doctor” is used but these ideas are also helpful with other primary care providers like nurse practitioners and physician’s assistants.
Choosing a Doctor
Here are some general qualities to look for:
- Clinical Skills and Knowledge: Does he or she have the training and specialty interest important to your child’s needs? A doctor with a special interest in child development, special needs, or a specific diagnosis might be just what you are looking for.
- Experience: Has the doctor cared for other children who have a similar diagnosis as your child or for children with developmental delays or disabilities in general? This kind of experience will help your doctor to be more aware of resources and possible services your child and family could benefit from.
- Mutual Respect and a Sense of Connection: Is he or she approachable? Does he or she make you feel comfortable? Do you like the interactions with your child? Do you trust this person with the health of your child? A doctor may be better in one area than another. Choosing a doctor may mean choosing a balance between technical skills, interpersonal skills, and experience.
- You decide what you and your child need right now. You may find that what you need changes over time.
Creating a Relationship
- Be a Partner: Decide what type of partnership you want with your child’s doctor. How do you want him or her to be involved in coordinating care and services for your child? What role do you want in making medical and health decisions?
- You should feel comfortable asking questions: Whatever type of partnership you have, you should feel comfortable asking questions, sharing your insights, and feel like you and the doctor are part of a team. In turn, you should be open to your doctor’s questions, insights and accept him or her as part of your child’s team.
- Be a Role Model: Show by example how you want to be treated and how you want your child to be treated. If you want to be listened to, then be a good listener, too. If you want your doctor to be delighted with your child, then show your delight in your child.
- Be Understanding: Doctors often must have appointment back-to-back, every 15 minutes or even sooner. If it seems like the doctor is in a hurry to move on to the next appointment, you are probably right!
- If you need more time, let her know and she should be willing to work this out.
- Let the Doctor Get to Know Your Whole Child: Talk about the good things as well as your concerns. Share pictures and stories so he or she can appreciate and get to know your child.
- Express Gratitude: Say thank you, in person or in writing. Let your doctor know what is helpful and that he or she is doing a good job.
- Don’t Expect Perfection: Every relationship has bumpy times and so will this one. Be willing to make changes, if needed. Recognize that doctor are human, too, and give him or her the change to make things better. If you are mostly pleased with your child’s doctor, then it is worth working through the rough times.
Practicing Good Communication
- A Two-way Conversation: Think of communicating with your doctor as having a friendly, respectful conversation. That means it is two-way and both of you should bring your questions, concerns, successes and hopes to the conversation.
- Get Clear About How to Communicate: Ask your doctor how to best communicate about your child’s care. Is there a good time during the day to call? Does she or he prefer that you first talk to the office nurse if you have questions between appointments? Are there ever situations when the doctor would want you to call him or her at home? Does your doctor welcome communication via email? How about fax?
- Feel Okay About Needing Advice Between Appointments: If you have a concern between appointments and feel that you need or want an answer from your child’s doctor, ask the nurse to have him or her call you. Explain that you are more worried than usual- for reasons you may not be able to explain just yet- and that you would really appreciate talking directly to him or her.
- Reflecting: Were you able to discuss your most important questions or issues? If not, is this okay with you or is there a plan for how you will get the information you need? Did you feel like a partner in your child’s health care team? Is there something you might want to do differently next time?
Deciding to Change Doctors
Most parents are pleased with their child’s doctor. But sometimes things just don’t feel right. Here are some questions to ask yourself:
- Does the way the office is run work for you?
- Is the doctor available when you need him or her?
- Are you often confused about recommendations and why certain treatments are prescribed?
- Do you feel like your concerns are not taken seriously? Does this make you question and doubt your instincts, or your doctor’s?
Trust your gut. If the relationship doesn’t feel right and you haven’t been able to make it better, then know that it is time to change doctors.
Try to do this in a positive way.
“Thanks for you’ve done for my child. We really appreciate the time you have spent with us.
But right now this is not the perfect fit for our family- I would like my child to see someone else.”
Getting the Most Out of an Appointment
- Scheduling: Schedule the doctor’s visit for the first appointment of the day or right after lunch if you would like to cut down on waiting time. If you have questions or concerns that may take more time than usual, ask the office staff to schedule a longer appointment. Your doctor and staff will appreciate the advance notice and you will feel less frustrated about not having enough time.
- Preparing: Think about what you would like to get out of the appointment ahead of time:
- Make a list of your questions, concerns, and other information you would like to share:It is okay to bring up things that don’t seem related to health but still matter to you and your child
- Decide what on your list is the most important to you: Ask the doctor if he or she would like a copy of your questions and concerns ahead of time. Emailing, faxing, or dropping your list off before the appointment might give more time for the doctor to prepare more complete responses to your questions.
Participating
Share your list of questions and concerns at the start of the appointment. The doctor likely has his own list for what he needs to accomplish during this visit. Together you might need to decide what you discuss during this appointment and what you discuss at a later time.
Things can move so quickly during appointments that it can be hard to remember all that is said. Here are some ideas to help with remembering:
- Take notes. Use the same notebook to write down your questions and the answers at each appointment. This will make it easier to keep track of all the information over time.
- Bring someone along who can help listen and take notes– and be there to support you, if needed.
- Ask if you can tape record your conversation
Sometimes you need to get the conversation back to your concerns. Here are some ways to do this:
- Ask a question. “What do you suggest about…”
- Tell a story about something going on in your child’s life that you want to discuss. “The other day at the IFSP meeting (or the speech therapy appointment, or the medical specialist…)…”
- Simply change the topic. “One other thing I would like to talk to you about is…”
- If the doctor gives you information that is difficult or hard to understand, ask if you can call him later to go over your questions.
- If your doctor can’t attend the IFSP or IEP meeting, ask for recommendations and input ahead of time. “This is what I am going to ask for in my child’s IFSP. What do you think”?
Share your doctor’s input with the IFSP or IEP team if your child has one. Your doctor can be your ally in helping you get the services you believe your child needs.
- Talk to him or her about what you think is needed. If your doctor agrees, ask him or her to write a letter to the IFSP team explaining your joint recommendations.
- Ask your doctor if a team member can call him to discuss the recommendations.
Update
During well child visits or other appointments, tell your doctor about the progress your child is making in services he is receiving through early intervention, the schools, or other programs. Ask any questions and share any concerns you have about the services.
Another fun and memorable way to update the doctor is to send an occasional picture of your child with a note highlighting his or her progress:
“Here is my daughter having fun at dinnertime. In early intervention, I learned how to encourage her to eat more table foods. She doesn’t gag and cry at the sight of food anymore and I’m not so worried about her growth. Early intervention helped me to have a better relationship with my daughter and helped my family, too– mealtimes are no longer a battle! Thanks for the referral!”
Advice and tools for families from the Bright Futures project at the American Academy of Pediatrics to help develop great partnerships between families and health care providers.
