Working with families as a family/parent coach, I get to hear a lot of the stressors that parents endure while raising their children. Although I tend to focus on the behaviors of the child and the relationship between the parents and the children, I can’t close my ears to the plight of families navigating the various systems they encounter while trying to access care for their child. In this series, I will talk about how parents can advocate for their child in areas like school, mental health, and medical care. The first in the series will focus on speaking up for your child’s medical care. To help with this specific area of advocating for your child, I enlisted the help of Debora Gilboa, MD, author of Get the Behavior You Want... Without Being the Parent You Hate!
So, what’s the deal with doctors (pediatricians, specialists, etc.) giving parents the cold shoulder when they are concerned about their child’s health? I asked myself this question after many talks with families trying to access the appropriate care for their children. Parents often complain that the doctor never has time to talk to them, or that their doctor always seems to dismiss the severity of their child’s symptoms. And, while the quick solution would be to change doctors immediately, I think the long term solution is to give parents the tools they need to really be advocates for their child’s medical care.
Gone are the days of “do as the doctor says”, especially now as we are in the era of prescription pills, quick cures, and over-hyped diagnoses. Parents also have more access to health care information than previous generations with websites and apps like WebMD and the like. But, until we get further into the future, parents are still at the mercy of healthcare professionals.
How To Find The Right Doctor?
Dr. Gilboa notes that the best way for parents to find the right doctor for their child is simply to ask. She states, “Ask your doctor, ‘Do you have experience managing ______________? How often have you dealt with this in the past and do you feel up to date about the current recommendations?’” It’s important to understand that just because they are a doctor does not mean that they have the experience to treat your child’s illness or medical concern. Dr. Gilboa added that, “No doctor who cares for kids should ever be offended by such a question.” And, I second this sentiment – when it comes to your child their medical degree does not give them the right to disrespectfully dismiss your questions or refute your claims. The dialoague should always include the collaboration of your thoughts and their medical advice.
In addition to finding the right doctor, I also encourage parents to seek the types of treatment they feel work best for their child and their family. Many doctors may attempt to push certain medications or treatments on you and almost force you to believe that this is the only treatment. However, I challenge parents to seek a second opinion, or look to other medical methods to compliment traditional medicine. “Anything you do to support your child's health should be something you discuss with your health care practitioner. So if you use naturopathy and allopathic medicine (the MD kind) then your allopath should know about your naturopathy and your naturopath should know about your use of western medicine,” says Dr. Gilboa. It can be scary to speak up with your child’s doctor, but remember, this is not about you trying to outwit the doctor – it’s about you finding the best course of treatment for your child’s overall health.
What To Ask At Follow-Ups
One of the common misconceptions I’ve discussed with parents is the follow-up visits or well child exams. Many parents feel that the doctor knows what to check and what to ask the parents. But, a lot of the time, the doctors are looking to you to let them know of any changes in your child’s medical history since the last visit – which can be up to 1 year prior. I strongly encourage my parents to keep a medical journal that lists all the major (and minor) ailments and illnesses that their child battled over the past year. I suggest listing injuries, sleep irregularities, growth spurts, menstrual schedules (for tween and teen girls), colds/flus, and even trips to other areas of the county or out of the county. Information like this is essential in helping your doctor know what is typical for your child’s age range and what could be problematic. Dr. Gilboa adds that there are three specific questions that you should definitely ask:
- Is my child growing and developing in a healthy way?
- Are you worried about anything?
- What should we be doing to help her continue to be healthy?
The Immunization Issue
Without getting into the controversy that surrounds whether you should or should not immunize your child, the fact remains that any medical decision you make for your child should be well researched and discussed with your child’s primary care physician. I err on the side of caution with this when it comes up for my parents, and suggest that unless your child is going to be homeschooled or away from other children that they think before making a final decision on immunizations. I also appreciate what Dr. Gilboa explains, “Immunizations save lives. As a doctor, I have seen people die of almost every disease that we can prevent with vaccines. I have seen kids suffer most of the possible side effects of vaccines. Vaccination is far safer. I vaccinate my own kids as early as I can with every vaccine I can - because I love them.”
Additionally, I’d like to state that there is some misinformation and informal research that suggests that vaccines are linked to certain disorders or certain side effects. Again, I can’t make a decision for the families I work with, or for you, but I strongly recommend that when making this decision you are doing so with the advice and direction of a skilled medical professional
Discussing The Link Between Mental and Physical Health
It’s not uncommon for families to be concerned whether their child’s medical concerns have a mental or physical basis. Oftentimes, parents are concerned that their primary care physician is not taking other factors into consideration when assessing their child’s whole medical picture. My suggestion is to ask for a mental health assessment along with a physical if you suspect that your child’s medical concerns are caused by mental or emotional triggers. Many doctors are either skilled at doing a brief mental health assessment or they can refer you to a mental health professional who can do a full assessment. Dr. Gilboa asserts that “most symptoms are firmly rooted in the body and the mind” and that trying to label symptoms as purely physical or purely emotional can be difficult to do. It’s not uncommon for your child to have both a physical and mental assessment, especially if after doing tests and blood work your doctor is still not sure of the cause of the behavior or illness.
While all of these tips may seem like common sense, I know that when parents are stressed and/or worried about their child’s health it is easy to forget what to say or ask. One thing that I always stress is that you are your child’s main advocator until they are old enough to speak up for themselves. You’re modeling for them how to be strong advocates for their own health. Dr. Gilboa puts it honestly, "You can't ever feel calm about your health or your child's if you don't have a strong, open, communicative and respectful relationship with the medical professionals you choose.” I couldn’t have said it better myself.