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How to Get What You Want from the Pediatrician

Sick children need to take all their medicine. One unnerving development in this age of miracle drugs is that parents frequently do not bother to follow through on the regimen. For instance, instead of receiving the complete 10-day course of penicillin for treatment of strep infections, 56 percent of children do not receive the drug by day three, and 71 percent don't receive it by day six. Often this is because the parent either doesn't believe it's really important to follow through or doesn't understand the directions. Doctors want parents to realize that if a child does not take the complete cycle of a medication, the original condition may come back stronger than before. If you are confused about administering the medicine but feel foolish asking the doctor to repeat the instructions, talk to the nurse. You are not alone; many people find the directions confusing.

Your child's health care depends on what you tell the doctor. "Ninety percent of our diagnosis is made by the history, by just talking. Ten percent is made by physical exam and lab studies," says Andrew Baumel. Parents, then, aren't just advocates in the pediatrician's office; their observations are the raw data doctors rely on most to treat children.

Yet even the most devoted parents are sometimes reluctant to be forthcoming with the pediatrician, for many of the same reasons adults cite. They may be embarrassed by a problem their child is having or afraid of what the doctor will discover. Many parents become distracted during the visit and forget to relate the most important information. Some don't want to appear ignorant, while others don't want to take up too much of the doctor's time.

It may be tempting to think that a really good pediatrician will uncover any serious problem with your child whether or not you are forthcoming. That is not how pediatricians view things. Good doctors will take a comprehensive history during the yearly checkup, but ultimately they depend on you to tell them anything you think might be relevant to your child's well-being.

Magic Words and Deeds in the Pediatrician's Office
The well-child checkup is where your most in-depth conversations with the pediatrician will take place. The best time to schedule one is April through September, on any day other than Monday. October through March is flu season, and Mondays are loaded with kids who got sick over the weekend. Parents tend to schedule a yearly checkup around the child's birthday because it's easy to remember, but that is not necessary. You will get a more relaxed doctor and possibly more time if you schedule during the slow months. If you want an extra-long visit or have special issues to discuss, ask the front office if taking the last appointment of the day will assure you more time.

Before your visit, take a few moments to think about your child's health, behavior, and development. Pediatricians expect you to report anything out of the ordinary, even if it doesn't seem to relate to health care. For instance, a child who suddenly starts getting into trouble in school and whose work takes a nosedive may be having social problems, but it's also possible that he is having difficulty with his vision or hearing.

Next, prepare a list of topics you wish to discuss with the doctor – and be sure to prioritize them. With only twenty minutes for the average visit, you may not get to discuss everything. Be sure to take paper and pencil along to jot down the doctor's advice. The Merck Manual reports that within 15 minutes after an office visit, some parents have already forgotten half the information. Parents tend to recall the first third of the visit best, and to remember more about diagnosis than treatment.

Doctors will usually run through a series of questions relating to your child's health and development, and of course you should answer these as specifically and clearly as you can. Keep your list of topics handy so you won't forget your own agenda when the doctor starts talking. For a smooth, satisfying office visit:

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From Say the Magic Words by Lynette Padwa. Copyright © 2005. Used by arrangement with Penguin Group (USA) Inc.

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