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How to Get What You Want from the Pediatrician

Absolute No-No's
Pediatricians are very consistent about what annoys them in the examining room. That's because they hear the same irritating comments from parents day in and day out. Avoid these and your doctor will love you for it.

Don't use the doctor as a threat. Says Andrew Baumel, "Every day I hear, 'You better be good or he's going to give you a shot.' What message does that send? You're putting up more barriers."

Don't talk to the pediatrician when she has the stethoscope on. She can't hear you, so she's not going to answer. If you speak loudly, she can't hear the heartbeat.

Don't try to squeeze a general checkup into a sick-child visit. The doctor probably won't do it, and even if he did, you would be getting a rushed, substandard checkup.

Don't try to piggyback one child onto another child's visit. With an average of 28 patients a day, the pediatrician's schedule is usually very tight. They dislike being pressured into seeing children they have not made time for.

Don't diagnose the problem for the doctor. You may be correct, but it's best to phrase it as a suspicion rather than as a foregone conclusion. Rather than announcing, "Brenda has strep again; she needs more Augmentin," say "Brenda seems to have the same symptoms she did last time she had strep," and let the doctor take it from there.

Don't be rude to the person at the front desk. It will get back to the doctor, the nurse practitioner, and the rest of the staff, and they will think less of you no matter how well-behaved you are with the doctor. If you want these people on your side when an emergency comes up, be nice to them now.

Covert Operations
As children grow older and less likely to confide in Mom and Dad, parents often turn to pediatricians for help in ferreting out the details of their lives. They routinely ask pediatricians to test their teenagers for drugs or sexually transmitted diseases, or to confirm that their daughters are still virgins. "I won't do it," states Margaret Fitzgerald about the latter issue. "It is truly impossible to tell. It's unfair because there's this assumption that you could examine a girl and say yes or no, but there's no expectation that you would examine a young man and come up with an answer." Fitzgerald also refuses to test for drugs or STDs without the adolescent's permission.

Confidential care for minors is a slippery slope for health-care providers. Each state has its own laws as to what kind of information about an adolescent can be kept confidential from a parent, and under what circumstances. The Allan Guttmacher Institute Web site, at www.agi-usa.org, lists confidentiality laws by state. But even if it were legal to attain details about your child's life without the child's knowledge, many pediatricians would be reluctant to cross that line. "I will use the issue as a way of facilitating a dialogue between the child and the parent," says Fitzgerald. She offers this somewhat world-weary observation for parents concerned about their teenagers' sex lives: "The idea of two fifteen-year-olds having sex does not warm my heart, but at least in all likelihood they're equally unempowered. It is more likely not to be an exploitative relationship at that age. Fourteen- and fifteen-year-old girls are rarely pregnant by fourteen- and fifteen-year-old boys. Usually it's by twenty-one- to twenty-five-year-old men."

Bidding Farewell to the Exam Room
When your child is eleven or twelve years old, it's time to introduce the idea of seeing the doctor alone. "Part of growing up into a young adult is the kid's responsibility to participate in his or her own health care," says Fitzgerald. "I generally start saying that to parents and children at an age when you couldn't surgically extract the parents from the exam room. The child wants the parent there, the parent wants to be there." When the children are twelve or thirteen, Fitzgerald will ask the child if she wants the parent to stay or leave. By the age of sixteen, a child should definitely be accustomed to going it solo at the doctor's office. The sooner they learn how to talk to effectively communicate with the doctor, the better.

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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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